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Hazukova R, Rezacova M, Pleskot M, Zadak Z, Cermakova E, Taborsky M. DNA damage and arterial hypertension. A systematic review and meta-analysis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:15-24. [PMID: 37916467 DOI: 10.5507/bp.2023.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/20/2023] [Indexed: 11/03/2023] Open
Abstract
Oxidative DNA damage markers (8OHdG, comet assay, gammaH2AX) are becoming widely used in clinical cardiology research. To conduct this review of DNA damage in relation to hypertension in humans, we used databases (e.g. PubMed, Web of Science) to search for English-language publications up to June 30, 2022 and the terms: DNA damage, comet assay, gammaH2AX, 8OHdG, strand breaks, and arterial hypertension. Exclusion criteria were: children, absence of relevant controls, extra-arterial hypertensive issues, animal, cell lines. From a total of 79526, 15 human studies were selected. A total of 902 hypertensive patients (pts): (comet: N=418 pts; 8OHdG: N=484 pts) and 587 controls (comet: N=203; 8OHdG: N=384) were included. DNA damage was significantly higher in hypertensive pts than healthy controls (comet 26.6±11.0 vs 11.7±4.07 arbitrary units /A.U./; P<0.05 and="" 8ohdg="" 13="" 1="" 4="" 12="" vs="" 6="" 97="" 2="" 67="" ng="" mg="" creatinine="" i=""> P<0.05) confirmed with meta-analysis for both. Greater DNA damage was observed in more adverse cases (concentric cardiac hypertrophy 43.4±15.4 vs 15.6±5.5; sustained/untreated hypertension 31.4±12.1 vs 14.2±5/35.0±5.0 vs 25.0 ±5.0; non-dippers 39.2±15.5 vs 29.4±11.1 A.U.; elderly 14.9±4.5 vs 9.3±4.1 ng/mg creatinine; without carvedilol 9.1±4.2 vs 5.7±3.9; with coronary heart disease 0.5±0.1 vs 0.2±0.1 ng/mL) (P<0.05) confirmed with meta-analysis. DNA damage correlated strongly positively with serum glycosylated haemoglobin (r=0.670; P<0.05) and negatively with total antioxidant status (r=-0.670 to -0.933; P<0.05). This is the first systematic review with meta-analysis showing that oxidative DNA damage was increased in humans with arterial hypertension compared to controls.
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Affiliation(s)
- Radka Hazukova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
- Department of Internal Medicine, Pardubice Regional Hospital, a.s., Pardubice, Czech Republic
- Department of Cardiology and Internal Medicine (Profi-Kardio, s.r.o.), Horice v Podkrkonosi, Czech Republic
| | - Martina Rezacova
- Department of Medical Biochemistry, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Miloslav Pleskot
- Department of Cardiology and Internal Medicine (Profi-Kardio, s.r.o.), Horice v Podkrkonosi, Czech Republic
| | - Zdenek Zadak
- Departments of Research and Development, University Hospital, Hradec Kralove, Czech Republic
| | - Eva Cermakova
- Department of Medical Biophysics, Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Vetrovsky T, Siranec M, Frybova T, Gant I, Svobodova I, Linhart A, Parenica J, Miklikova M, Sujakova L, Pospisil D, Pelouch R, Odrazkova D, Parizek P, Precek J, Hutyra M, Taborsky M, Vesely J, Griva M, Semerad M, Bunc V, Hrabcova K, Vojkuvkova A, Svoboda M, Belohlavek J. Lifestyle Walking Intervention for Patients With Heart Failure With Reduced Ejection Fraction: The WATCHFUL Trial. Circulation 2024; 149:177-188. [PMID: 37955615 PMCID: PMC10782943 DOI: 10.1161/circulationaha.123.067395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Physical activity is pivotal in managing heart failure with reduced ejection fraction, and walking integrated into daily life is an especially suitable form of physical activity. This study aimed to determine whether a 6-month lifestyle walking intervention combining self-monitoring and regular telephone counseling improves functional capacity assessed by the 6-minute walk test (6MWT) in patients with stable heart failure with reduced ejection fraction compared with usual care. METHODS The WATCHFUL trial (Pedometer-Based Walking Intervention in Patients With Chronic Heart Failure With Reduced Ejection Fraction) was a 6-month multicenter, parallel-group randomized controlled trial recruiting patients with heart failure with reduced ejection fraction from 6 cardiovascular centers in the Czech Republic. Eligible participants were ≥18 years of age, had left ventricular ejection fraction <40%, and had New York Heart Association class II or III symptoms on guidelines-recommended medication. Individuals exceeding 450 meters on the baseline 6MWT were excluded. Patients in the intervention group were equipped with a Garmin vívofit activity tracker and received monthly telephone counseling from research nurses who encouraged them to use behavior change techniques such as self-monitoring, goal-setting, and action planning to increase their daily step count. The patients in the control group continued usual care. The primary outcome was the between-group difference in the distance walked during the 6MWT at 6 months. Secondary outcomes included daily step count and minutes of moderate to vigorous physical activity as measured by the hip-worn Actigraph wGT3X-BT accelerometer, NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity C-reactive protein biomarkers, ejection fraction, anthropometric measures, depression score, self-efficacy, quality of life, and survival risk score. The primary analysis was conducted by intention to treat. RESULTS Of 218 screened patients, 202 were randomized (mean age, 65 years; 22.8% female; 90.6% New York Heart Association class II; median left ventricular ejection fraction, 32.5%; median 6MWT, 385 meters; average 5071 steps/day; average 10.9 minutes of moderate to vigorous physical activity per day). At 6 months, no between-group differences were detected in the 6MWT (mean 7.4 meters [95% CI, -8.0 to 22.7]; P=0.345, n=186). The intervention group increased their average daily step count by 1420 (95% CI, 749 to 2091) and daily minutes of moderate to vigorous physical activity by 8.2 (95% CI, 3.0 to 13.3) over the control group. No between-group differences were detected for any other secondary outcomes. CONCLUSIONS Whereas the lifestyle intervention in patients with heart failure with reduced ejection fraction improved daily steps by about 25%, it failed to demonstrate a corresponding improvement in functional capacity. Further research is needed to understand the lack of association between increased physical activity and functional outcomes. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT03041610.
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Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Michal Siranec
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Tereza Frybova
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Iulian Gant
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Iveta Svobodova
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Ales Linhart
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Jiri Parenica
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Marie Miklikova
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Lenka Sujakova
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - David Pospisil
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Radek Pelouch
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Daniela Odrazkova
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Petr Parizek
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Jan Precek
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Martin Hutyra
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Milos Taborsky
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Jiri Vesely
- Edumed sro, Broumov, and Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic (J.V.)
| | - Martin Griva
- Department of Cardiology, Tomas Bata Regional Hospital, Zlin, Czech Republic (M.G.)
| | - Miroslav Semerad
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Vaclav Bunc
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Karolina Hrabcova
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Adela Vojkuvkova
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Jan Belohlavek
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
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Spacek M, Vacha J, Kaminek M, Hutyra M, Nykl R, Sluka M, Taborsky M. Comparison of angiographic estimation and invasive hemodynamic measurement of the significance of non-infarct-related residual stenoses in ST-elevation myocardial infarction patients. Arch Med Sci Atheroscler Dis 2023; 8:e169-e176. [PMID: 38283928 PMCID: PMC10811533 DOI: 10.5114/amsad/172971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/27/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Up to 50% of patients with ST elevation myocardial infarction (STEMI) have ≥ 50% stenosis in a major non-infarct-related artery. Several studies have evaluated the prognostic value of the completion of revascularization with overall inconclusive results. Selection of the stenoses was based on the angiographic evaluation, invasive hemodynamic measurement or the combined approach. It is unknown whether such a selection provides correlation of comparable patient groups. Material and methods We enrolled 51 patients (62.7 ±10.2 years) with acute STEMI and at least one residual (50-90%) stenosis in a non-infarct-related major coronary artery (excluding left main coronary artery). Overall 65 stenoses (67.9 ±10.7%) were evaluated angiographically following primary percutaneous coronary intervention and the hemodynamic significance was estimated with respect to the stenosis severity, caliber of the arterial segment, localization of the stenosis (proximity) as well as the estimated size of the supplied vascular territory. During subsequent hospitalization, invasive measurement of the hemodynamic significance using fractional flow reserve (FFR) was performed to guide the final revascularization strategy (FFR value of ≤ 0.80 considered significant). Results Based on angiographic evaluation, a total of 44 stenoses would be recommended for treatment, whereas only 31 stenoses were revascularized based on FFR measurement. Moreover, visual evaluation and hemodynamic measurement were discrepant in 27 of 65 (41.5%) stenoses. Conclusions We observed a weak correlation between visual angiographic evaluation and invasive hemodynamic measurement. More stents would be implanted based on angiographic evaluation compared to FFR measurement.
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Affiliation(s)
- Miloslav Spacek
- Department of Internal Medicine I – Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Jan Vacha
- Department of Internal Medicine I – Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Milan Kaminek
- Department of Nuclear Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I – Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Radomir Nykl
- Department of Internal Medicine I – Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Martin Sluka
- Department of Internal Medicine I – Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I – Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
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Taborsky M, Skala T, Fedorco M, Doupal V, Sovova I, Jarkovsky J, Benesova K, Bezdekova M, Vicha M, Danek J, Kautzner J. Effectiveness of ICD therapy in real clinical practice. The Olomouc ICD Registry. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:225-235. [PMID: 34916673 DOI: 10.5507/bp.2021.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/08/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Clinical parameters linked to a low benefit of ICD implantation and increased mortality risks are needed for an individualized assessment of potential benefits and risks of ICD implantation. METHODS Analysis of a prospective registry of all patients hospitalized from 2009 to 2019 in a single centre for a first implantation of any type of ICD. RESULTS A total of 2,681 patients were included in the registry. Until the end of follow-up (38.4 ± 29.1 months), 682 (25.4%) patients died. The one-year mortality in all patients, the one-year CV mortality, the three-year mortality in all patients, and the three-year CV mortality were 7.8%, 5.7%, 20.6%, and 14.8%, respectively. There was a statistically significant difference when the subgroups were compared according to the type of cardiomyopathy. No significant difference was found between primary and secondary prevention and between the types of devices. Male gender, age ≥ 75 years, diabetes mellitus, and atrial fibrillation were associated with a significantly increased mortality risk. CONCLUSION In an analysis of a long-term follow-up of 2,681 ICD patients, we found no mortality difference between patients with ischemic or non-ischemic cardiomyopathy and in the device type. A higher mortality risk was found in men, patients older than 75 years, diabetics, and those with atrial fibrillation.
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Affiliation(s)
- Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Tomas Skala
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Marian Fedorco
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Vlastimil Doupal
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Ingrid Sovova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Jiri Jarkovsky
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O. BOX 60, 128 01 Praha 2, Czech Republic
- Institute of Biostatistics and Analyses at the Faculty of Medicine of the Masaryk University (IBA FM MU) in Brno, Czech Republic
| | - Klara Benesova
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O. BOX 60, 128 01 Praha 2, Czech Republic
- Institute of Biostatistics and Analyses at the Faculty of Medicine of the Masaryk University (IBA FM MU) in Brno, Czech Republic
| | - Monika Bezdekova
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O. BOX 60, 128 01 Praha 2, Czech Republic
| | - Marek Vicha
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic
| | - Josef Danek
- Department of Cardiology, Central Military Hospital Prague, U Vojenske nemocnice 1200, 169 02 Praha 6, Czech Republic
| | - Josef Kautzner
- Institute for Clinical and Experimental Medicine, Videnska 1958, 140 21 Praha 4, Czech Republic
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Branny M, Osmancik P, Kala P, Poloczek M, Herman D, Neuzil P, Hala P, Taborsky M, Stasek J, Haman L, Chovancik J, Cervinka P, Holy J, Kovarnik T, Zemanek D, Havranek S, Vancura V, Peichl P, Tousek P, Hozman M, Lekesova V, Jarkovsky J, Novackova M, Benesova K, Widimsky P, Reddy VY. Nonprocedural bleeding after left atrial appendage closure versus direct oral anticoagulants: A subanalysis of the randomized PRAGUE-17 trial. J Cardiovasc Electrophysiol 2023; 34:1885-1895. [PMID: 37529864 DOI: 10.1111/jce.16029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/07/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION Observational studies have shown low bleeding rates in patients with atrial fibrillation (AF) treated by left atrial appendage closure (LAAC); however, data from randomized studies are lacking. This study compared bleeding events among patients with AF treated by LAAC and nonvitamin K anticoagulants (NOAC). METHODS The Prague-17 trial was a prospective, multicenter, randomized trial that compared LAAC to NOAC in high-risk AF patients. The primary endpoint was a composite of a cardioembolic event, cardiovascular death, and major and clinically relevant nonmajor bleeding (CRNMB) defined according to the International Society on Thrombosis and Hemostasis (ISTH). RESULTS The trial enrolled 402 patients (201 per arm), and the median follow-up was 3.5 (IQR 2.6-4.2) years. Bleeding occurred in 24 patients (29 events) and 32 patients (40 events) in the LAAC and NOAC groups, respectively. Six of the LAAC bleeding events were procedure/device-related. In the primary intention-to-treat analysis, LAAC was associated with similar rates of ISTH major or CRNMB (sHR 0.75, 95% CI 0.44-1.27, p = 0.28), but with a reduction in nonprocedural major or CRNMB (sHR 0.55, 95% CI 0.31-0.97, p = 0.039). This reduction for nonprocedural bleeding with LAAC was mainly driven by a reduced rate of CRNMB (sHR for major bleeding 0.69, 95% CI 0.34-1.39, p = .30; sHR for CRNMB 0.43, 95% CI 0.18-1.03, p = 0.059). History of bleeding was a predictor of bleeding during follow-up. Gastrointestinal bleeding was the most common bleeding site in both groups. CONCLUSION During the 4-year follow-up, LAAC was associated with less nonprocedural bleeding. The reduction is mainly driven by a decrease in CRNMB.
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Affiliation(s)
- Marian Branny
- Department of Cardiology, Cardiocenter, Hospital Podlesí a.s., Trinec, Czech Republic
- Department of Internal Medicine and Cardiology, Faculty of Medicin, University Hospital Ostrava, Ostrava, Czech Republic
| | - Pavel Osmancik
- Department of Cardiology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic
| | - Petr Kala
- Department of Internal Medicine and Cardiology, University Hospital Brno and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - Martin Poloczek
- Department of Internal Medicine and Cardiology, University Hospital Brno and Medical Faculty of Masaryk University, Brno, Czech Republic
| | - Dalibor Herman
- Department of Cardiology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic
| | - Petr Neuzil
- Department of Cardiology, Cardiocenter, Na Homolce Hospital, Prague, Czech Republic
| | - Pavel Hala
- Department of Cardiology, Cardiocenter, Na Homolce Hospital, Prague, Czech Republic
| | - Milos Taborsky
- Department of Cardiology, Cardiocenter, University Hospital Olomouc, Olomouc, Czech Republic
| | - Josef Stasek
- 1st Department of Internal Medicine, Faculty of Medicine, University Hospital Hradec Kralove, Charles University Prague, Prague, Czech Republic
| | - Ludek Haman
- 1st Department of Internal Medicine, Faculty of Medicine, University Hospital Hradec Kralove, Charles University Prague, Prague, Czech Republic
| | - Jan Chovancik
- Department of Cardiology, Cardiocenter, Hospital Podlesí a.s., Trinec, Czech Republic
| | - Pavel Cervinka
- Department of Cardiology, Krajská zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic
| | - Jiri Holy
- Department of Cardiology, Krajská zdravotni a.s., Masaryk Hospital and UJEP, Usti nad Labem, Czech Republic
| | - Tomas Kovarnik
- Cardiocenter, 2nd Internal Clinic-Cardiology and Angiology, General Faculty Hospital, Charles University, Prague, Czech Republic
| | - David Zemanek
- Cardiocenter, 2nd Internal Clinic-Cardiology and Angiology, General Faculty Hospital, Charles University, Prague, Czech Republic
| | - Stepan Havranek
- Cardiocenter, 2nd Internal Clinic-Cardiology and Angiology, General Faculty Hospital, Charles University, Prague, Czech Republic
| | - Vlastimil Vancura
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Pilsen, Czech Republic
| | - Petr Peichl
- Cardiocenter, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petr Tousek
- Department of Cardiology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic
| | - Marek Hozman
- Department of Cardiology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic
| | - Veronika Lekesova
- Department of Cardiology, Cardiocenter, Na Homolce Hospital, Prague, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Martina Novackova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Klara Benesova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Petr Widimsky
- Department of Cardiology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, Prague, Czech Republic
| | - Vivek Y Reddy
- Department of Cardiology, Cardiocenter, Na Homolce Hospital, Prague, Czech Republic
- Icahn School of Medicine at Mount Sinai, Helmsley Electrophysiology Center, New York, New York, USA
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Sluka M, Hutyra M, Nykl R, Ostransky J, Furst T, Petrova P, Precek J, Hudec S, Taborsky M. Risk stratification using growth differentiation factor 15 in patients undergoing transcatheter aortic valve implantation. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:263-271. [PMID: 35416185 DOI: 10.5507/bp.2022.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
AIMS Growth differentiation factor 15 (GDF15) shows potential predictive value in various cardiac conditions. We investigated relationships between GDF15 and clinical or procedural outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) in order to propose clinically useful predictive risk stratification model. METHODS This prospective single-center registry enrolled 88 consecutive patients with severe symptomatic aortic stenosis treated with TAVI. Clinical parameters were collected and biomarkers including GDF-15 were measured within 24 h before TAVI. All relevant clinical outcomes according to the Valve Academic Research Consortium-2 were collected over the follow-up period. RESULTS The cohort included 52.3% of females. The mean age of study participants was 81 years; the mean Society of Thoracic Surgeons (STS) score and logistic EuroSCORE were 3.6% and 15.4%, respectively. The mortality over the entire follow-up period was 10.2%; no death was observed within the first 30 days following TAVI. Univariate analysis showed significant associations between GDF15 and mortality (P=0.0006), bleeding (P=0.0416) and acute kidney injury (P=0.0399). A standard multivariate logistic regression model showed GDF-15 as the only significant predictor of mortality (P=0.003); the odds ratio corresponding to an increase in GDF15 of 1000 pg/mL was 1.22. However, incremental predictive value was not observed when the STS score was combined with GDF15 in this predictive model. CONCLUSIONS Based on our observations, preprocedural elevated GDF15 levels are associated with increased mortality and demonstrate their additional value in predicting adverse clinical outcomes in a TAVI population.
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Affiliation(s)
- Martin Sluka
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
| | - Radomir Nykl
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
| | - Jiri Ostransky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
| | - Tomas Furst
- Department of Mathematical Analysis and Applications of Mathematics, Faculty of Science, Palacky University Olomouc, Czech Republic
| | - Pavla Petrova
- Department of Clinical Biochemistry, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
| | - Stepan Hudec
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, I. P. Pavlova 6, 779 00, Czech Republic
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Spacek M, Vacha J, Precek J, Hutyra M, Nykl R, Sluka M, Taborsky M. Complete revascularization of multivessel coronary artery disease in patients with ST elevation acute coronary syndrome - for whom and when? A comprehensive review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023; 167:16-23. [PMID: 35703363 DOI: 10.5507/bp.2022.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Atherosclerosis is the most common cause of coronary steno-occlusive disease and acute myocardial infarction is the leading cause of death in industrialized countries. In patients with acute ST elevation myocardial infarction (STEMI), there is unquestionable evidence that primary percutaneous coronary intervention providing recanalization of the infarct related artery (IRA) is the preferred reperfusion strategy. Nevertheless, up to 50% of patients with STEMI have multivessel coronary artery disease defined as at least 50% stenosis exclusive of IRA. There is conflicting data regarding the optimal treatment strategy and timing in such patients. Currently, it is assumed that stable patients might benefit from complete revascularization particularly in reducing the need for future unplanned procedures but only culprit lesion should be treated during index procedure in unstable patients. In this article, we provide a comprehensive overview of this important and currently highly debated topic.
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Affiliation(s)
- Miloslav Spacek
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Jan Vacha
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Radomir Nykl
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Martin Sluka
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
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Pavlu L, Vicha M, Flasik J, Petrkova J, Taborsky M, Kacirkova T, Holy O. A comparison of heart failure patients with reduced ejection fraction in the Moravian Midlands Registry with the LCZ696 patients in the Paradigm-HF trial. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023. [PMID: 36748670 DOI: 10.5507/bp.2023.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND AIMS There are limited data on real clinical practice in heart failure patients in the Czech Republic. We analysed the clinical parameters from the Moravian Midlands Registry (MMR) and compared them to LCZ696 patients in the Paradigm-HF trial. The Moravian Midlands Registry is a retrospective patient database from two outpatient cardiology centres in the Czech Republic. The Paradigm-HF is a large-scale prospective randomized multicentre trial with more than 8000 individuals with stabilized chronic heart failure. METHODS A retrospective analysis of heart failure with reduced ejection fraction patients from two outpatient cardiology centres in the Czech Republic from October 2016 to December 2019. RESULTS Patients in the MMR were younger (60.5 ± 10.7 vs 63.8 ± 11.5 years, P<0.05), had a higher body mass index (30.3 ± 5.0 vs 28.1 ± 5.5, P<0.05) and higher serum creatinine level (101.9 ± 36.0 vs 99.9 ± 26.5 µmol/L, P<0.05). MMR patients had lower left ventricular ejection fraction (27.8 ± 6.9 vs 29.6 ± 6.1%, P<0.05). The serum N-terminal pro-B-type natriuretic peptide, [2563.5 (377-3536) vs 1631 (885-3154), was non significantly higher P=0.07]. Pharmacotherapy use differed for mineralocorticoid antagonist (91.4% in MMR vs 54.2% in Paradigm-HF), and digoxin (13.5% vs 29.2%). Beta-blocker use was similar (96.2% vs 93.1%) as was angiotensin-converting enzyme (ACE) inhibitors - (71.2% vs 78.0%) and angiotensin-receptor blockers - ARB (27.9% vs 22.2%). Dosages of the commonly used ACE inhibitors at the screening visit (Paradigm-HF) / before angiotensin receptor-neprilysin inhibitor administration (MMR) differed significantly only for ramipril (7.0 ± 3.1 mg vs 4.8 ± 2.9 mg, P<0.05), dosages of ARB were - losartan (67.1 ± 30.2 vs 39.6 ± 32.0 mg, P=0.09) and valsartan (181.5 ± 71.1 vs 130.9 ± 82.2 mg, P=0.07). There was a substantial difference in device-based therapy (ICD in 60.6%, CRT 25.9% in MMR vs 14.9% and 7.0% in Paradigm-HF). CONCLUSION The differences between the groups for the majority of clinical parameters compared were minimal, except for younger age, higher body mass index and serum creatinine level and lower left ventricular ejection fraction and substantially lower dosage of administered ramipril prior to commencing sacubitril/valsartan therapy. There was a higher prevalence of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy (CRT) in the MMR group.
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Affiliation(s)
- Ludek Pavlu
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Marek Vicha
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Jakub Flasik
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Jana Petrkova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
- Department of Pathological Physiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Tereza Kacirkova
- Science and Research Centre, Faculty of Health Sciences, Palacky University Olomouc, Olomouc, Czech Republic
| | - Ondrej Holy
- Science and Research Centre, Faculty of Health Sciences, Palacky University Olomouc, Olomouc, Czech Republic
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Nykl R, Hutyra M, Cechakova E, Precek J, Vindis D, Richter D, Taborsky M. High incidence of acute and subacute ischaemic foci on brain MRI in patients with a diagnosis of acute pulmonary embolism and confirmed patent foramen ovale. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023. [PMID: 36691764 DOI: 10.5507/bp.2023.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Pulmonary embolism (PE) is a common and potentially life-threatening diagnosis when a certain amount of thrombotic mass obstructs blood flow through the pulmonary circulation. The finding of acute and subacute ischaemic foci on magnetic resonance imaging (MRI) of the brain in a group of patients with this diagnosis in whom we demonstrate the presence of patent foramen ovale (PFO) by transoesophageal echocardiography (TEE) is surprisingly high. METHODS A total of 129 patients with a diagnosis of pulmonary embolism (confirmed by computed tomography with contrast agent, CTA) who consented to further examination were examined by transthoracic echocardiography (TTE) and transoesophageal echocardiography (TEE) with contrast agent, underwent magnetic resonance imaging of the brain according to a specific protocol, and underwent a comprehensive baseline laboratory examination. RESULTS In our group of 129 patients, we found the presence of PFO in 36.4% (n=47) of them. A total of 5.4% (n=7) patients had asymptomatic acute and subacute ischaemic changes on brain MRI; 6 of them had concomitant PFO. The statistically significant correlation between troponin levels and the presence of pathological findings on MRI and the trend of a similar correlation for NT-proBNP values is also very interesting finding. CONCLUSIONS The association between the presence of PFO and the occurrence of symptomatic or asymptomatic findings on brain MRI is a well-known fact (the issue of paradoxical embolism) but the high frequency of acute and subacute lesions on brain MRI in the group of patients with a diagnosis of acute PE is surprising.
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Affiliation(s)
- Radomir Nykl
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Eva Cechakova
- Department of Radiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - David Vindis
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - David Richter
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Hudec S, Hutyra M, Precek J, Latal J, Nykl R, Spacek M, Sluka M, Sanak D, Tudos Z, Pastucha D, Taborsky M. Determination of the prevalence and predictors of ventricular thrombus with assessment of the risk of systemic embolization to the CNS in patients after acute myocardial infarction using magnetic resonance imaging, echocardiography and cardiac markers - a prospective, unicentric, observational study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023. [PMID: 38214057 DOI: 10.5507/bp.2023.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Left ventricular thrombus (LVT) formation is one of the well-known and serious complications of acute myocardial infarction (AMI) due to the risk of systemic arterial embolization (SE). To diagnose LVT, echocardiography (TTE) is used. Late gadolinium-enhanced cardiovascular magnetic resonance (DE-CMR) is the gold standard for diagnosing LVT. OBJECTIVES The aim of this observational study was to determine the role of transthoracic echocardiography and cardiac markers in predicting the occurrence of LVT compared with a reference cardiac imaging (DE-CMR) and to determine the risk of systemic embolization to the CNS using brain MRA. METHODS Seventy patients after MI managed by percutaneous coronary intervention (localization: 92.9% anterior wall, 7% other; median age 58.7 years) were initially examined by transthoracic echocardiography (TTE, n=69) with a focus on LVT detection. Patients were then referred for DE-CMR (n=55). Laboratory determination of cardiac markers (Troponin T and NTproBNP) was carried out in all. Brain MRA was performed 1 year apart (n=51). RESULTS The prevalence of LVT detected by echocardiography: (n=11/69, i.e. 15.9%); by DE-CMR: (n=9/55, i.e. 16.7%). Statistically significant parameters to predict the occurrence of LVT after AMI (cut off value): (a) detected by echocardiography: anamnestic data - delay (≥ 5 hours), echocardiographic parameters - left atrial volume index (LAVI≥ 32 mL/m2), LV EF Simpson biplane and estimated (≤ 42%), tissue Doppler determination of septal A wave velocity (≤ 7.5cm/s); (b) detected by DE-CMR: anamnestic data - delay (≥ 13 hours), DE-CMR parameters - left ventricular end-diastolic diameter (≥ 54mm). The value of cardiac markers (Troponin T and NTproBNP in ng/L) in LVT detected by echocardiography did not reach statistical significance. In LVT detected by DE-CMR, NTproBNP was statistically significantly increased at 1 month after AMI onset (no optimal cut-off value could be determined). There was no statistically significant association between the LVT detection (both modalities) and the occurrence of clinically manifest and silent cardioembolic events. CONCLUSION Our study confirmed a relatively high prevalence of LVT in the high-risk group of patients with anterior wall STEMI. Due to the low prevalence of thromboembolic complications, no significant association between the LVT detection and the occurrence of a cardioembolic event was demonstrated.
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Affiliation(s)
- Stepan Hudec
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Jan Latal
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Radomir Nykl
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Miloslav Spacek
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Martin Sluka
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Daniel Sanak
- Complex Cerebrovascular Centre, Department of Neurology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Zbynek Tudos
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Dalibor Pastucha
- Department of Rehabilitation and Sports Medicine, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Ostrava, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
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Hutyra M, Sanak D, Kral M, Dornak T, Precek J, Hudec S, Navratil K, Kocianova E, Koubek F, Kanovsky P, Taborsky M. Transoesophageal echocardiography findings in young patients with cryptogenic ischemic stroke. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and purpose
The cause of ischemic stroke (IS) remains often unclear in young patients. Relevant structural heart abnormities with known embolic potential may represent cause of IS also in young population. The use of transoesophageal echocardiography (TEE) allows reliable detection of most relevant structural pathologies. The aim was to assess frequency and spectrum of relevant cardiac abnormities in young IS patients.
Subjects and methods
The study set consisted of young acute IS patients <50 years enrolled in the prospective HISTORY (Heart and Ischemic STrOke Relationship studY) study, registered on ClinicalTrials.gov NCT01541163). In all patients, the brain ischemia was confirmed on CT or MRI. Admission ECG, serum specific cardiac markers, TEE, 24-hour and 3-week ECG-Holter were performed in all patients.
Results
Out of 1284 patients enrolled in the HISTORY study, 135 (73 males, mean age 40.2±8.1 years) were <40 years. In total, the relevant TEE abnormities were present in 47 (35%) of these patients. Patent foramen ovale (PFO) with evident left to right shunt was detected in 38 (28%) patients, with significant right to left shunt in 25 (19%) patients, and other atrial septal defect with clinically significant bidirectional flow in 4 (3%) patients. Significant valvular heart disease was present in 2 (1%) patients (1 bicuspid aortic valve with moderate aortic regurgitation, 1 chronic severe mitral regurgitation), and 4 (3%) patients severe left ventricular systolic dysfunction (left ventricular ejection fraction ≤35%) due to idiopathic dilated cardiomyopathy. Left atrial myxoma was detected in one patient.
Conclusion
The relevant structural abnormities with embolic potential were detected using TEE in 35% of young IS patients. Routine use of TEE to elucidate the causes of stroke, has a role especially in young patients who present with cryptogenic stroke and no cardiovascular risk factors, as well as in the setting of a PFO associated with a deep venous thrombosis.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): IGA LF UP, MH CZ - DRO
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Affiliation(s)
- M Hutyra
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology , Olomouc , Czechia
| | - D Sanak
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology , Olomouc , Czechia
| | - M Kral
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology , Olomouc , Czechia
| | - T Dornak
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology , Olomouc , Czechia
| | - J Precek
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology , Olomouc , Czechia
| | - S Hudec
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology , Olomouc , Czechia
| | - K Navratil
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology , Olomouc , Czechia
| | - E Kocianova
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology , Olomouc , Czechia
| | - F Koubek
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology , Olomouc , Czechia
| | - P Kanovsky
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology , Olomouc , Czechia
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology , Olomouc , Czechia
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Taborsky M, Aiglova R, Fedorco M, Bradac P, Flasik J, Danek J, Schee A. Detection of arrhythmias in patients with cardiac amyloidosis using implantable ECG recorders. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Cardiac Amyloidosis frequently results in congestive cardiac failure and arrhythmias, from a disruption in cardiac substrate with subsequent electro-mechanical remodeling. Arrhythmias are vary based on the amyloidosis type. Conduction defects and atrial arrhythmias are more prevalent in transthyretin amyloidosis compared with light chain amyloidosis, and this difference might be a reflection of the longer survival time in the former.
Methods
112 transthyretin amyloidosis (TTR) patients with completed underlying diagnosis including 99mTc-DPD scan, genetic testing and endomyocardioal biopsy (27%) without documented arrhythmias were randomized to standard clinical follow-up including arrhythmias or implantation of an ECG loop recorder (ILR). The classic FU took place in a heart failure clinic, and the group of patients with ILR was monitored by remote control with automatic daily report of the occurrence of arrhythmias by an independent organization. If an arrhythmia was detected, the patient was contacted immediately. The mean follow-up time for both groups was 17±7 months.
Results
The results are summarized in Table 1.
Conclusions
Currently, there is no consensus on the absolute benefit that ICDs in patients with cardiac amyloidosis. When non-sustained VT and syncope are captured and documented, ICD implantation for prevention of SCD in CA is most likely a reasonable approach. However, intensive monitoring of arrhythmias in patients with CA using ILR can lead to accurate and early detection of ventricular arrhythmias in particular and early initiation of ICD treatment as a prevention of SCD. Documentation of ventricular arrhythmias in CA patients was significantly higher by ILR (p<0.005) and was a clear predictor of patient survival (HR 2.51).
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Taborsky
- University Hospital Olomouc , Olomouc , Czechia
| | - R Aiglova
- University Hospital Olomouc , Olomouc , Czechia
| | - M Fedorco
- University Hospital Olomouc , Olomouc , Czechia
| | - P Bradac
- University Hospital Olomouc , Olomouc , Czechia
| | - J Flasik
- University Hospital Olomouc , Olomouc , Czechia
| | - J Danek
- Central Military Hospital Prague , Prague , Czechia
| | - A Schee
- Hospital Karlovy Vary, Cardiology , Karlovy Vary , Czechia
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Obrova J, Sovova E, Ivanova K, Furstova J, Taborsky M. Let It Beat: How Lifestyle and Psychosocial Factors Affect the Risk of Sudden Cardiac Death-A 10-Year Follow-Up Study. Int J Environ Res Public Health 2022; 19:ijerph19052627. [PMID: 35270315 PMCID: PMC8909732 DOI: 10.3390/ijerph19052627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022]
Abstract
(1) Background: The aim of this study was to evaluate the lifestyle and occurrence of psychosocial factors in patients with a high risk of sudden cardiac death (SCD) and to explore their effect on the occurrence of the adequate therapy of an Implantable Cardioverter Defibrillator (ICD). (2) Methods: In this retro-prospective single-centre study, a group of patients aged 18-65 years old, who underwent the first ICD implantation for primary (PP) or secondary (SP) prevention between 2010-2014, was studied. The control group consisted of pair-matched (age ± 5 years, gender) respondents without a high risk of SCD. Information was obtained using a self-reported questionnaire and hospital electronic health records. The adequacy of ICD therapy was evaluated regularly until 31 January 2020. Multivariate logistic regression models were employed to assess the risk of SCD. (3) Results: A family history of SCD, coronary artery disease, diabetes mellitus and depression significantly aggravated the odds of being at a high risk of SCD. The occurrence of an appropriate ICD therapy was significantly associated with being in the SP group, BMI, education level and TV/PC screen time. (4) Conclusions: Lifestyle and psychosocial factors have been confirmed to affect the risk of SCD. Early identification and treatment of coronary artery disease and its risk factors remain the cornerstones of preventive effort. Further research is needed to evaluate the complex nature of psychosocial determinants of cardiac health.
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Affiliation(s)
- Jana Obrova
- Department of Internal Medicine I—Cardiology, University Hospital Olomouc, 779 00 Olomouc, Czech Republic;
- Correspondence: ; Tel.: +420-588-44-5429
| | - Eliska Sovova
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, 779 00 Olomouc, Czech Republic;
| | - Katerina Ivanova
- Department of Public Health, Faculty of Medicine and Dentistry, Palacký University Olomouc, 779 00 Olomouc, Czech Republic;
| | - Jana Furstova
- Olomouc University Social Health Institute, Palacký University Olomouc, 779 00 Olomouc, Czech Republic;
| | - Milos Taborsky
- Department of Internal Medicine I—Cardiology, University Hospital Olomouc, 779 00 Olomouc, Czech Republic;
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Vicha M, Skala T, Jelinek L, Pavlu L, Jarkovsky J, Dusek L, Benesova K, Taborsky M. Pharmacotherapy of diabetes mellitus in patients with heart failure - a nation-wide analysis of contemporary treatment. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021. [PMID: 34897297 DOI: 10.5507/bp.2021.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM Retrospective national sub-analysis of antidiabetic pharmacotherapy in patients with diabetes mellitus (DM) and heart failure (HF) based on data reported to the National Register of Paid Health Services in the Czech Republic between 2012-2018. METHODOLOGY AND RESULTS In 2012, there were 75,022 patients with HF and DM (i.e. 42.5% of patients with HF), 6 years later 117,265 (i.e. 41.0% of HF patients in 2018). The most represented antidiabetic drug was metformin (45.6%). Of the insulins and analogues, glargine showed the largest positive trend (5.8% 2012; 14.8% 2018). Empagliflozin was the most prescribed SGLT-2 inhibitor (1.8% in 2018). A decrease in prescribing was observed for saxagliptin (0.5% 2012; 0.1% 2018) and for sulfonylurea derivates - gliclazide (13.0% 2012; 10.3% in 2018) and glimepiride (12.9% 2012; 9.0% 2018). Linagliptin was the most prescribed dipeptidyl peptidase inhibitor (0.7% 2012; 6.8% 2018). CONCLUSION In the Czech Republic, between 2012 and 2008, there was an increase in prevalence of patients with heart failure and concomitant diabetes mellitus, their proportion being similar. In correspondence with other registries, metformin was used mostly. A positive trend was observed in prescription of DDP-4 and SGLT-2 inhibitors, while there was a significant decrease in patients taking sulfonylureas.
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Affiliation(s)
- Marek Vicha
- Department of Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Tomas Skala
- Department of Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Libor Jelinek
- Department of Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Ludek Pavlu
- Department of Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jiri Jarkovsky
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O.BOX 60, Prague, Czech Republic.,Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ladislav Dusek
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O.BOX 60, Prague, Czech Republic.,Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Klara Benesova
- Institute of Health Information and Statistics of the Czech Republic, Palackeho nam. 4, P.O.BOX 60, Prague, Czech Republic.,Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Milos Taborsky
- Department of Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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Obrova J, Sovova E, Kocianova E, Taborsky M. Sudden cardiac death - a known unknown? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021; 166:258-266. [PMID: 34782798 DOI: 10.5507/bp.2021.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 11/05/2021] [Indexed: 11/23/2022] Open
Abstract
Sudden cardiac death (SCD) is a major medical, economic and social problem. The estimated annual number of SCDs is approximately 4 million cases worldwide. Approximately 50% of SCDs are unexpected first manifestations of cardiac disease. The survival rate after out-of-hospital cardiac arrest is low even in countries with the most advanced health care systems. It all emphasizes the importance of prevention, in which implantable cardioverter-defibrillators play a dominant role. However, our ability to recognize high-risk patients remains insufficient. Moreover, a declining rate of shockable rhythm as the initial recording has been reported in the last decades. Despite numerous SCD studies and undisputed progress, there are still many unanswered questions.
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Affiliation(s)
- Jana Obrova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Eliska Sovova
- Department of Exercise Medicine and Cardiovascular Rehabilitation, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Eva Kocianova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
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Osmancik P, Herman D, Neuzil P, Hala P, Taborsky M, Kala P, Poloczek M, Stasek J, Haman L, Branny M, Chovancik J, Cervinka P, Holy J, Kovarnik T, Zemanek D, Havranek S, Vancura V, Peichl P, Tousek P, Lekesova V, Jarkovsky J, Novackova M, Benesova K, Widimsky P, Reddy VY. Left Atrial Appendage Closure versus Non-Warfarin Oral Anticoagulation in Atrial Fibrillation: 4-Year Outcomes of PRAGUE-17. J Am Coll Cardiol 2021; 79:1-14. [PMID: 34748929 DOI: 10.1016/j.jacc.2021.10.023] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/05/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The PRAGUE-17 trial demonstrated that left atrial appendage closure (LAAC) was non-inferior to non-warfarin oral anticoagulants (NOAC) for preventing major neurological, cardiovascular or bleeding events in high-risk patients with atrial fibrillation (AF). OBJECTIVE To assess the pre-specified long-term (4-year) outcomes in PRAGUE-17. METHODS PRAGUE-17 was a randomized non-inferiority trial comparing percutaneous LAAC (Watchman or Amulet) with NOACs (95% apixaban) in non-valvular AF patients with a history of cardioembolism, clinically-relevant bleeding, or both CHA2DS2-VASc > 3 and HASBLED > 2. The primary endpoint was a composite of cardioembolic events (stroke, transient ischemic attack, or systemic embolism), cardiovascular death, clinically-relevant bleeding, or procedure/device-related complications (LAAC group only). The primary analysis was modified intention-to-treat (mITT). RESULTS We randomized 402 AF patients (201 per group, age 73.3±7.0 years, 65.7% male, CHA2DS2-VASc 4.7+1.5, HASBLED 3.1+0.9). After 3.5 years median follow-up (1,354 patients-years), LAAC was non-inferior to NOAC for the primary endpoint by mITT (subdistribution hazard ratio[sHR] 0.81, 95% CI 0.56-1.18; p=0.27; p for non-inferiority=0.006). For the components of the composite endpoint, the corresponding sHRs (and 95% CIs) were 0.68 (0.39-1.20; p=0.19) for cardiovascular death, 1.14 (0.56-2.30; p=0.72) for all-stroke/TIA, 0.75 (0.44-1.27; p=0.28) for clinically-relevant bleeding, and 0.55 (0.31-0.97; p=0.039) for non-procedural clinically-relevant bleeding. The primary endpoint outcomes were similar in the per-protocol [sHR 0.80 (95% CI 0.54-1.18), p=0.25] and on-treatment [sHR 0.82 (95% CI 0.56-1.20), p=0.30] analyses. CONCLUSION In long-term follow-up of PRAGUE-17, LAAC remains non-inferior to NOACs for preventing major cardiovascular, neurological or bleeding events. Furthermore, non-procedural bleeding was significantly reduced with LAAC.
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Affiliation(s)
- Pavel Osmancik
- Cardiocenter, Third Faculty of Medicine, Charles University Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Dalibor Herman
- Cardiocenter, Third Faculty of Medicine, Charles University Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Petr Neuzil
- Cardiocenter, Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Pavel Hala
- Cardiocenter, Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Milos Taborsky
- Cardiocenter, Dept. of Cardiology, University Hospital Olomouc, Czech Republic
| | - Petr Kala
- Clinic of Cardiology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Martin Poloczek
- Clinic of Cardiology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Josef Stasek
- 1(st) Department of Internal Medicine, Faculty of Medicine, University Hospital Hradec Kralove, Charles University Prague, Czech Republic
| | - Ludek Haman
- 1(st) Department of Internal Medicine, Faculty of Medicine, University Hospital Hradec Kralove, Charles University Prague, Czech Republic
| | - Marian Branny
- Department of Cardiology, Cardiocenter, Hospital Podlesí a.s., Trinec, Czech Republic
| | - Jan Chovancik
- Department of Cardiology, Cardiocenter, Hospital Podlesí a.s., Trinec, Czech Republic
| | - Pavel Cervinka
- Department of Cardiology, Krajská zdravotni a.s., Masaryk hospital and UJEP, Usti nad Labem, Czech Republic
| | - Jiri Holy
- Department of Cardiology, Krajská zdravotni a.s., Masaryk hospital and UJEP, Usti nad Labem, Czech Republic
| | - Tomas Kovarnik
- Cardiocenter, 2nd internal clinic - Cardiology and Angiology, Charles University, General Faculty Hospital, Prague Czech Republic
| | - David Zemanek
- Cardiocenter, 2nd internal clinic - Cardiology and Angiology, Charles University, General Faculty Hospital, Prague Czech Republic
| | - Stepan Havranek
- Cardiocenter, 2nd internal clinic - Cardiology and Angiology, Charles University, General Faculty Hospital, Prague Czech Republic
| | - Vlastimil Vancura
- Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Pilsen, Czech Republic
| | - Petr Peichl
- Cardiocenter, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petr Tousek
- Cardiocenter, Third Faculty of Medicine, Charles University Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Veronika Lekesova
- Cardiocenter, Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martina Novackova
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Klara Benesova
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Widimsky
- Cardiocenter, Third Faculty of Medicine, Charles University Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Vivek Y Reddy
- Cardiocenter, Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic; Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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Nykl R, Precek J, Sluka M, Hudec S, Richter D, Heinc P, Taborsky M. Interventional prevention of paradoxical embolism as the gold standard: End of discussion? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021; 165:241-248. [PMID: 34158673 DOI: 10.5507/bp.2021.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
Paradoxical embolism is one of the predominant causes of cryptogenic stroke and interventional secondary prevention, i.e., closure of the patent foramen ovale (PFO), is a much discussed issue. This review aims to provide a complex perspective on this topic, aggregates and comments on the available data and current guidelines. Several large trials were performed, some of which proved the superiority of PFO closure over pharmacotherapy while others have not. Studies detecting significant superiority of intervention worked with disproportionately high representation of large shunts compared to the general population. Other controversies also remain, such as the lack of comparison of the effect of modern anticoagulant/antiplatelet treatment to PFO closure or the risk of developing unwanted side effects after intervention, and these are discussed in detail. PFO closure is a suitable method for secondary prevention of paradoxical embolism and, therefore, cryptogenic stroke. However, this is only true for carefully selected patient populations and such selection is of the utmost importance in deciding on interventional or conservative treatment.
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Affiliation(s)
- Radomir Nykl
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Martin Sluka
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Stepan Hudec
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - David Richter
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Petr Heinc
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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Aiglova R, Taborsky M, Lazarova M, Pavlu L, Danek J, Precek J, Schee A, Gloger V, Cernicek V, Vicha M, Skala T. Angiotensin-converting enzyme inhibitors, angiotensin-II-receptor antagonists and angiotensin-receptor blocker/neprilysin inhibitor utilization in heart failure patients: Sub-analysis of a nation-wide population-based study in the Czech Republic. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021; 166:322-327. [PMID: 34092792 DOI: 10.5507/bp.2021.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022] Open
Abstract
AIMS Sub-analysis of a retrospective nation-wide observational analysis of heart failure (HF) epidemiology reported to the Czech National Registry of Reimbursed Health Services between 2012 and 2018 aimed at angiotensin-converting enzyme inhibitors (ACEI), angiotensin-II-receptor antagonists (ARB) and angiotensin receptor blocker/neprilysin inhibitor (ARNI) use. METHODS AND RESULTS ACEi and ARBs were generally used in 87.6% of all HF patients in 2012 (n=154 627); 84.5% in 2013 (n=170 861); 83.5% in 2014 (n=186 963); 81.6% in 2015 (n=198 844); 80.1% in 2016 (n=205 793); 78.0% in 2017 (n=212 152) and in 76.7% in 2018 (n=219 235). In a sub-analysis of patients with a medical procedure and/or examination using an I50.x ICD code accounted for in the given year, ACEi and ARBs were generally used in 99.3% in 2012 (n=63 250); 96% in 2013 (n=62 241); 95.2% in 2014 (n=64 414); 93.3% in 2015 (n=65 217); 91.8% in 2016 (n=65 236); 90.1% in 2017 (n=65 761) and in 88.6% in 2018 (n=66 332). In 2018, the majority of patients with HF were prescribed ramipril (n=49 909; 17.5%) and perindopril (n=44 332; 15.5%). The mostly prescribed ARBs in 2018 were telmisartan (n=18 669; 6.5%); losartan (n=13 935; 4.9%) and valsartan (n=4 849; 1.7%). In 24.5% of cases, ACEIs and ARBs were prescribed in a fixed combination with another drug. ARNI became gradually more prescribed from 2018 (n=9 659 in November 2020). CONCLUSION In an analysis of ACEIs, ARBs and ARNIs utilization in all patients treated for heart failure in the given year in the whole country, we found a comparable rate of drug prescription in comparison with specific heart failure registries. This indicates a good translation of current standard of care into common clinical practice. Ramipril and perindopril remained the mostly prescribed ACEIs and telmisartan became the mostly prescribed ARB. Since 2018, ARNIs began to be widely prescribed.
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Affiliation(s)
- Renata Aiglova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Marie Lazarova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Ludek Pavlu
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Josef Danek
- Department of Internal Medicine, Military University Hospital Prague, Prague, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
| | - Alexander Schee
- Cardio center, Regional Hospital Karlovy Vary, Karlovy Vary, Czech Republic
| | - Vit Gloger
- Bata's Regional Hospital, Zlin, Czech Republic
| | | | - Marek Vicha
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Olomouc, Czech Republic
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Taborsky M, Skala T, Aiglova R, Fedorco M, Kautzner J, Jandik T, Vancura V, Linhart A, Valek M, Novak M, Kala P, Polasek R, Roubicek T, Schee A, Hindricks G, Dagres N, Hatalaj R, Jarkovsky J. Cardiac Resynchronization and Defibrillator Therapy (CRT-D) or CRT Alone (CRT-P) in patients with dilated cardiomyopathy and heart failure without late gadolinium enhancement (LGE) cardiac magnetic resonance imaging (CMRI) high-risk markers - CRT-REALITY study - Study design and rationale. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2021; 166:173-179. [PMID: 33724264 DOI: 10.5507/bp.2021.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/05/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Primary preventive implantation of implantable defibrillator (ICD) is according to current guidelines indicated in patients with heart failure NYHA (New York Heart Association) class II/III and LVEF <35%. Thanks to advances in heart failure pharmacotherapy, a decrease in mortality could render a benefit of ICD insufficient to justify its implantation in some patients. METHODS Study design: multicenter, prospective, randomized, controlled trial evaluating the benefit of implantation of Cardiac Resynchronization and Defibrillator Therapy (CRT-D) or CRT Alone (CRT-P) in non-ischemic patients with reduced left ventricle ejection fraction (LVEF) and optimal pharmacotherapy without significant mid-wall myocardial fibrosis detected by cardiac magnetic resonance (CMR). The primary end-point: Re-hospitalization for heart failure, ventricular tachycardia, major adverse cardiac events (MACE). The secondary end-points: Sudden cardiac death, cardiovascular death, resuscitated cardiac arrest or sustained ventricular tachycardia, device-related complications, and change in quality of life. Course of the study: After a pharmacotherapy is optimized and significant mid-wall myocardial fibrosis excluded, patients will be randomized 1:1 to CRT-P or CRT-D implantation. DISCUSSION If our hypothesis is confirmed, this could provide evidence for the management of these patients with a significant impact on common daily praxis and health care expenditures. TRIAL REGISTRATION ClinicalTrials.gov, NCT04139460.
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Affiliation(s)
- Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Tomas Skala
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Renata Aiglova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Marian Fedorco
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Josef Kautzner
- Cardiology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Tomas Jandik
- Department of Cardiology, University Hospital Pilzen, Czech Republic
| | - Vlastimil Vancura
- Department of Cardiology, University Hospital Pilzen, Czech Republic
| | - Ales Linhart
- The Internal Clinic of Cardiology and Angiology of the First Faculty of Medicine and General Teaching Hospital, Czech Republic
| | - Martin Valek
- The Internal Clinic of Cardiology and Angiology of the First Faculty of Medicine and General Teaching Hospital, Czech Republic
| | | | - Petr Kala
- University Hospital Brno, Czech Republic
| | | | | | - Alexandr Schee
- Private Cardiovascular Center Karlovy Vary Kardio KV L.T.D., Czech Republic
| | | | | | - Robert Hatalaj
- Institute for Biostatistics and Analyses of Faculty of Medicine Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute for Biostatistics and Analyses of Faculty of Medicine Brno, Czech Republic
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20
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Taborsky M, Aiglova R, Lazarova M, Pavlu L, Danek J, Precek J, Schee A, Gloger V, Vicha M, Skala T. Beta-blockers utilization in heart failure patients: Sub-analysis of a nation-wide population-based study in the Czech Republic. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:402-407. [PMID: 33325457 DOI: 10.5507/bp.2020.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/20/2020] [Indexed: 01/08/2023] Open
Abstract
AIMS Sub-analysis of a retrospective nation-wide observational analysis of heart failure (HF) epidemiology reported to the Czech National Registry of Reimbursed Health Services between 2012 and 2018 aimed at beta-blockers (BBs) utilization. METHODS AND RESULTS The beta-blockers were generally used in 81.8% of all patients treated for HF in 2012 (n=52 140); 81.8% in 2013 (n=53 058); 83.1% in 2014 (n=56 221); 82.1% in 2015 (n=57 421); 83.3% in 2016 (n=59 187); 82.2% in 2017 (60 058) and in 81.4% in 2018 (n=60 966). In 2018, the majority of patients treated for HF were prescribed metoprolol (22 974; 30.7%) and bisoprolol (21 001; 28%). Carvedilol was prescribed in 7 331 patients treated for HF (9.8%), nebivolol in 5 392 HF patients. Despite its primary indication, betaxolol was used in 2 341 patients treated for HF (3.1%). All other beta-blockers were used in less than 1% of HF patients. In some of the mostly used BBs, their prescription in patients treated for HF changed in the last years (metoprolol 32.4% in 2012, 30.7% in 2018; bisoprolol 20.3% in 2012, 28% in 2018; carvedilol 18.3% in 2012, 9.8% in 2018; nebivolol 2.5% in 2012, 7.2% in 2018; betaxolol 4.2% in 2012, 3.1% in 2018). CONCLUSION In an analysis of beta-blockers utilization in all patients treated for heart failure in the given year in the whole country, we have found only slightly lower amount of drug prescription in comparison with specific heart failure registries. This indicates a good translation of current standard of care into common clinical practice. Metoprolol remained the mostly prescribed drug. The prescription of bisoprolol and nebivolol has increased at the expense of carvedilol.
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Affiliation(s)
- Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, 775 20 Olomouc, Czech Republic
| | - Renata Aiglova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, 775 20 Olomouc, Czech Republic
| | - Marie Lazarova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, 775 20 Olomouc, Czech Republic
| | - Ludek Pavlu
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, 775 20 Olomouc, Czech Republic
| | - Josef Danek
- Department of Internal Medicine, Military University Hospital, Prague, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, 775 20 Olomouc, Czech Republic
| | - Alexander Schee
- Cardio center, Regional Hospital Karlovy Vary, Karlovy Vary, Czech Republic
| | - Vit Gloger
- Bata's Regional Hospital, Zlin, Czech Republic
| | - Marek Vicha
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, 775 20 Olomouc, Czech Republic
| | - Tomas Skala
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, 775 20 Olomouc, Czech Republic
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Skala T, Moravec O, Santavy P, Steriovsky A, Taborsky M. Electrophysiological findings after bilateral thoracoscopic atrial fibrillation ablation using irrigated bipolar radiofrequency energy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Thoracoscopic atrial fibrillation (AF) ablation (TARAFS) using irrigated bipolar radiofrequency energy should result in posterior left atrial (LA) wall isolation.
Purpose
To assess the long-term durability of this “box” lesion and the extent of additional ablation needed to achieve AF non-inducibility.
Methods
22 patients with AF recurrence after bilateral TARAFS for persistent AF had a radiofrequency catheter ablation (RFA) at least three months after TARAFS. Electroanatomical voltage map was done in all patients prior to any ablation.
Results
Out of 22 patients, the box lesion was not completed in 15 (68.2%). In these 15 patients, 12 had no signs of any prior ablation in endocardium (voltage >0.5mV), 2 had right pulmonary veins (PVs) isolated and 1 had left PVs isolated.
At the end of RFA, box lesion was finished in all 15 patients and AF non-inducibility was achieved in 18 patients. For this endpoint, besides box lesion, mitral line and extensive coronary sinus ablation was necessary in 14, extensive CFAE ablation in 7 patients. Cavotricuspid isthmus line block was done in all patients.
Conclusion
A minimally invasive thoracoscopic box-lesion ablation is considered to be a safe and effective method of stand-alone AF treatment. However, in a considerable amount of patients no signs of prior ablation are found on electroanatomical voltage map. Gaps thus cannot be found and a completely new complex ablation must be done. In a lot of patients, additional ablation is needed besides box lesion to achieve non-inducibility.
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): University Hospital Olomouc
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Affiliation(s)
- T Skala
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
| | - O Moravec
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
| | - P Santavy
- Palacky University- Faculty of Medicine and Dentistry, Department of Cardiosurgery, Olomouc, Czechia
| | - A Steriovsky
- Palacky University- Faculty of Medicine and Dentistry, Department of Cardiosurgery, Olomouc, Czechia
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
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Taborsky M, Latal J, Fedorco M, Skala T, Novak M, Kozak M, Krivan L, Gloger V, Schee A. Essential role of PET-CT in the management of patients with severe infectious complication CIEDS: multicentre study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
With the increasing number of implanted cardiac pacemakers, ICDs and CRTs, the number of serious infectious complications of these procedures increases significantly, especially in the longer term from the primary implantation. The systematic solution is in most cases endovasal extraction of these systems.
Methods
In a multicenter, prospective, randomized, controlled trial evaluating the benefit of CIEDS infection management in 277 patients, a conventional approach using blood cultures, microbiological examinations and TEE versus innovative management of these patients using PET-CT was compared. PET-CT examination is able to differentiate very well the infection of the implant pocket (Figure A) against bacterial endocarditis (Figure B). Thanks to this, it is possible to individualize the management of the patient and to shorten the dates of hospitalization, resp. time to re-implantation of the new system in patients without the presence of bacterial endocarditis.
Results
The results of the multicentre study are summarized in Table 1.
Conclusions
A comprehensive examination of patients with CDRIE using PET-CT significantly shortens hospital stay, time of antibiotic therapy and, as a consequence, leads to a lower incidence of serious complications of extraction procedures.
PET-CT in CDRIE patients
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Taborsky
- University Hospital Olomouc, Olomouc, Czechia
| | - J Latal
- University Hospital Olomouc, Olomouc, Czechia
| | - M Fedorco
- University Hospital Olomouc, Olomouc, Czechia
| | - T Skala
- University Hospital Olomouc, Olomouc, Czechia
| | - M Novak
- St. Anne University Hospital Brno (FNUSA), Brno, Czechia
| | - M Kozak
- Masaryk University, Brno, Czechia
| | - L Krivan
- Masaryk University, Brno, Czechia
| | - V Gloger
- Bata Regional Hospital Zlin, Zlin, Czechia
| | - A Schee
- KKN District Hospital, Karlovy Vary, Czechia
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Nykl R, Precek J, Spacek M, Sluka M, Hudec S, Heinc P, Taborsky M. Radial artery pseudoaneurysm as a rare very late complication of transradial cardiac catheterization. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:452-453. [PMID: 32597422 DOI: 10.5507/bp.2020.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022] Open
Abstract
AIMS Here, we report a case of very late (70+ days) development of pseudoaneurysm on the site of sheath insertion in a 60- year old woman. METHODS The patient underwent cardiac catheterization using transradial approach. RESULTS Despite the transradial approach, which is generally considered as a suitable prevention of this problem, and despite absence of any periprocedural complications, the patient developed a pseudoaneurysm after more than 70 days from the procedure. CONCLUSIONS In some cases, a pseudoaneurysm may develop extremely late after cardiac catheterization. Such an extremely late development of pseudoaneurysm has not been described in literature so far.
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Affiliation(s)
- Radomir Nykl
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Milos Spacek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Martin Sluka
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Stepan Hudec
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Petr Heinc
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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Moravec O, Skala T, Klementova O, Skalova J, Hutyra M, Precek J, Fedorco M, Cernicek V, Tudos Z, Zapletalova J, Taborsky M. General anesthesia or conscious sedation in paroxysmal atrial fibrillation catheter ablation. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:162-168. [PMID: 32285847 DOI: 10.5507/bp.2020.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 03/10/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Catheter ablation of paroxysmal atrial fibrillation (AF) can be performed under general anesthesia or conscious sedation. The influence of type of anesthesiology care on procedural characteristics and ablation outcome in patients in whom intracardiac echocardiography (ICE) and elimination of adenosine-mediated dormant conduction (DC) is used is not entirely known. METHODS 150 patients with paroxysmal AF were randomized to point-by-point radiofrequency catheter isolation of pulmonary veins (PVI) under general anesthesia (n=77) or conscious sedation (n=73). Adenosine-mediated dormant conduction was eliminated in all patients. Antiarrhythmic medication was discontinued after PVI. During twelve months of follow-up, all patients underwent four times 7-day ECG monitorings. RESULTS There was no difference between groups in AF recurrence (28.6% vs. 31.5%, P=0.695). Patients in conscious sedation had longer procedure times (160 ± 32.1 vs. 132 ± 31.5 min, P<0.001), longer RF energy application times (40 ± 15 vs. 29 ± 11 min, P<0.001) and longer fluoroscopy times (6.2 min ± 5.3 vs. 4.3 min ± 2.2, P<0.001) with similar complication rates. CONCLUSION Conscious sedation is not inferior to general anesthesia in regard to arrhythmia recurrence or complication rates of catheter ablation of paroxysmal atrial fibrillation. However, it is associated with longer procedure times, longer time of radiofrequency energy application and longer fluoroscopy times.
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Affiliation(s)
- Ondrej Moravec
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Tomas Skala
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Olga Klementova
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Czech Republic
| | - Jitka Skalova
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Marian Fedorco
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Vlastimil Cernicek
- Cardiovascular Centre, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Zbynek Tudos
- Department of Radiology, University Hospital Olomouc, Czech Republic
| | - Jana Zapletalova
- Department of Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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Naef J, Taborsky M. Correction to 'Commodity-specific punishment for experimentally induced defection in cooperatively breeding fish'. R Soc Open Sci 2020; 7:200365. [PMID: 32431914 PMCID: PMC7211859 DOI: 10.1098/rsos.200365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
[This corrects the article DOI: 10.1098/rsos.191808.].
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Hudec S, Hutyra M, Precek J, Latal J, Nykl R, Spacek M, Sluka M, Sanak D, Tudos Z, Navratil K, Pavlu L, Taborsky M. Acute myocardial infarction, intraventricular thrombus and risk of systemic embolism. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 164:34-42. [DOI: 10.5507/bp.2020.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/03/2020] [Indexed: 01/02/2023] Open
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Hutyra M, Sanak D, Kral M, Veverka T, Dornak T, Divisova P, Precek J, Spacek M, Latal J, Kanovsky P, Taborsky M. P3709Risk of recurrent cerebral ischemia in young patients with cryptogenic ischemic stroke and patent foramen ovale. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The cause of ischemic stroke (IS) remains often unclear in young patients. Relevant structural heart abnormities with known embolic potential may represent cause of IS also in young population. A persistent foramen ovale (PFO) is a known risk factor for paradoxical embolism, including ischemic stroke (IS).
Aims
The aims of our prospective study were to assess the rates of recurrent ischemic stroke events in young IS patients with PFO during a 35-month follow-up period (FUP) on effective antiplatelet therapy (OAT) and to evaluate a potential relationship with the presence of PFO on transesophageal echocardiography (TEE).
Methods
The study set consisted of young acute IS patients <50 years enrolled in the prospective HISTORY (Heart and Ischemic STrOke Relationship studY) study, NCT01541163). In all patients, the brain ischemia was confirmed on CT or MRI. Admission ECG, serum specific cardiac markers, transesophageal echocardiography, 24-hour and 3-week ECG-Holter were performed in all patients.
Results
Out of 980 patients enrolled in the HISTORY study, 260 patients were younger than 50 years and 185 (56% males, mean age 41±8 years) patients were classified as cryptogenic IS in ASCOD classification. PFO was diagnosed in 60 patients (32%). Six new clinically apparent recurrent ischemic brain events were recorded during a 35-month FUP. No significant difference was found in the presence of IS recurrence between patient group with PFO and without PFO (2 [3.2% patients with PFO] versus 4 [3.2% without PFO] of young IS patients, P=0.99).
Conclusion
The presence of PFO was not associated with a higher risk of new brain ischemic lesions in young patients with with cryptogenic ischemic stroke during a 35-month follow-up period. Number of recurrent clinical IS is relatively small, thus achieved results may be not so robust.
Acknowledgement/Funding
Grant support IGA MZ CR NT/14288-3, AZV MZ CR 17-30101A, IGA LF UP Olomouc (2016-2018), FNOL SUG No. 87-85
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Affiliation(s)
- M Hutyra
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
| | - D Sanak
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czechia
| | - M Kral
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czechia
| | - T Veverka
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czechia
| | - T Dornak
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czechia
| | - P Divisova
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czechia
| | - J Precek
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
| | - M Spacek
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
| | - J Latal
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czechia
| | - P Kanovsky
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czechia
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czechia
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Kala P, Cervenka L, Taborsky M, Sadowski J, Skaroupkova P, Kompanowska- Jezierska E. P3513Sex-related differences in the outcome of congestive heart failure: study on rats treated with ACEi alone or combined with soluble epoxide hydrolase inhibitor. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
In search for new therapeutic measures of congestive heart failure (CHF) attention focused on the role of epoxyeicosatrienoic acids (EETs), cytochrome P450-dependent epoxygenase pathway metabolites of arachidonic acid, with antihypertensive and organ-protective actions. The EETs are rapidly broken-down by soluble epoxide hydrolase (sEH). Blocking sEH and increasing tissue EETs bioavailability had antihypertensive and cardio- and renoprotective effects. The studies of the biological mechanisms underlying the sex-related differences in the CHF and in the responses to new pharmacological measures are missing. The rat model in which CHF is induced by volume overload by creation of the aorto-caval fistula (ACF) is recommended for preclinical studies by American Heart Association. It has been noticed that the hypertensive rat transgenic for the mouse Ren-2 renin gene (TGR) presents a unique angiotensin II-dependent model of hypertension. We found that male ACF TGR displayed tissue deficiency of EETs, and increasing intrarenal EETs levels by pharmacological blockade of sEH attenuated the progression of CHF in male ACF TGR. However, we did not examine if this effect occurs also in female ACF TGR.
Purpose
The aim was to establish if sex-related differences, if present, are demonstrable with standard treatment with ACEi alone and with the combined treatment with ACEi and sEHi.
Methods
Male and female TGR rats were randomly assigned either to ACF procedure or to sham-operation. One week after the procedure rats were divided into the 8 experimental groups (sham-operated male TGR + placebo, ACF male TGR + placebo, ACF male TGR + ACEi, ACF male TGR + ACEi + sEHi, sham-operated female TGR + placebo, ACF female TGR + placebo, ACF female TGR + ACEi, ACF female TGR + ACEi + sEHi). C-AUCB was used as an sEHi and trandolapril as ACEi, both in drinking water in doses previously tested. The follow-up period was 50 weeks and the primary end-point was death from any cause.
Results
All sham-operated male and female TGR survived until the end of experiment. All untreated male ACF TGR animals died by week 20. In contrast, untreated female ACF survived in the rate of 32%. The treatment with ACEi improved survival rate similary in male as well as female ACF TGR (74% and 65%). The combined treatment with ACEi and sEHi worsened the survival in male ACF TGR as compared with ACF TGR + ACEi (38%). In contrast, the combined treatment with ACEi and sEHi in female ACF TGR significantly improved the course and the final survival rate (84%) as compared with female ACF TGR + ACEi alone.
Picture 1
Conclusions
The study suggests that in CHF individuals in whom hypertension and increased RAS activity run in parallel, the patients' sex is the co-determinant of CHF progression. In particular it can influence the effectiveness of the therapeutic measures applied to slow it down. Therefore, in pre- and clinical studies the sex-related differences should be seriously considered.
Acknowledgement/Funding
Ministry of Health of the Czech Republic grant no. 17- 28220A; Grant Agency of Charles University, project number 32218
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Affiliation(s)
- P Kala
- Motol University Hospital, Prague, Czechia
| | - L Cervenka
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia
| | - M Taborsky
- University Hospital Olomouc, Olomouc, Czechia
| | - J Sadowski
- Mossakowski Medical Research Centre, Warsaw, Poland
| | - P Skaroupkova
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czechia
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Bulkova V, Sanak D, Tomek A, Brozman M, Gandalovicova J, Kovarikova D, Pelikanova V, Mikulik R, Nevsimalova M, Monhart Z, Palanova A, Taborsky M, Linhart A, Fiala M. P1455Atrial fibrillation detection by integrated trans-telephonic ECG monitoring after cryptogenic stroke in the years 2016–2018 in the Czech and Slovak Republics. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cryptogenic strokes can be estimated to ∼3500 patients in the Czech (CZ) and 2000 patients in Slovak (SK) republics. Systematic screening in these patients and methods of ECG monitoring are generally uneven across different hospitals and districts.
Purpose
Assessment of integrated screening for atrial fibrillation (AF) after cryptogenic stroke was launched in collaboration with Czech Society of Cardiology and stroke centers in the year 2016.
Methods
Patients with stroke of unknown source within the last 3 weeks, and without AF/atrial tachycardia (AT) detected during in-hospital ECG monitoring, were referred by stroke centers into integrated database of the MDT center, who subsequently contacted the patients and shipped the loop/continuous ECG recorder (Vitaphone, Faros, ECGPocket) with automatic data transmission over cell phone to them directly home or into aftercare unit. ECG monitoring was scheduled for 3 weeks, and the data were regularly edited and evaluated to inform the referring stroke centers in case of AF detection. Upon termination of ECG monitoring, the device was returned to the MDT center, and the final report was sent to the referring physician for eventual treatment decision.
Results
The project involved 36 stroke centers in the CZ and 11 centers in SK. A total of 3.120 patients (65±17 years, 46% females) were monitored for 21.6±5.3 days. AF was detected in 308 (9.9%) patients. Additional findings included: AV block II-III in 62 (2%), NSVT over 5 QRS complexes in 249 (8%), sinus pauses over 4 seconds in 17 (0.5%), and regular SVT over 5 minutes in 69 (2.2%) patients. Total monitoring costs amounted to 374 400 € (120 €/patient). In CZ, the counts of monitored patients in 2016, 2017, 2018 were 302, 754, and 1148, which accounted for ∼10%, 21%, and 32%, respectively, of eligible patients.
Conclusion
Systematic screening of patients after cryptogenic stroke with integrated ECG monitoring has become adopted within 3 years to cover 39% of eligible patients in CZ. Besides approximately 10% AF/AT detection, clinically significant arrhythmias were identified in another 13% of patients.
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Affiliation(s)
- V Bulkova
- MDT-International Center for Telemedicine, department of cardiology, Brno, Czechia
| | - D Sanak
- University Hospital Olomouc, Neurology Clinic, Olomouc, Czechia
| | - A Tomek
- Motol University Hospital, Neurology Clinic, Prague, Czechia
| | - M Brozman
- University Hospital of Nitra, Neurology Clinic, Nitra, Slovakia
| | - J Gandalovicova
- MDT-International Center for Telemedicine, department of cardiology, Brno, Czechia
| | - D Kovarikova
- MDT-International Center for Telemedicine, department of cardiology, Brno, Czechia
| | - V Pelikanova
- MDT-International Center for Telemedicine, department of cardiology, Brno, Czechia
| | - R Mikulik
- International Clinical Research Center, Neurology departmen, Brno, Czechia
| | - M Nevsimalova
- Regional Hospital of Ceske Budejovice, Neurology departmen, Ceske Budejovice, Czechia
| | - Z Monhart
- Regional Hospital of Ceske Budejovice, Neurology departmen, Ceske Budejovice, Czechia
| | - A Palanova
- MDT-International Center for Telemedicine, department of cardiology, Brno, Czechia
| | - M Taborsky
- Czech Society of Cardiology, Brno, Czechia
| | - A Linhart
- Czech Society of Cardiology, Brno, Czechia
| | - M Fiala
- Czech Society of Cardiology, Brno, Czechia
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Petrkova J, Borucka J, Kalab M, Klevcova P, Michalek J, Taborsky M, Petrek M. Increased Expression of miR-146a in Valvular Tissue From Patients With Aortic Valve Stenosis. Front Cardiovasc Med 2019; 6:86. [PMID: 31294031 PMCID: PMC6606704 DOI: 10.3389/fcvm.2019.00086] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 06/06/2019] [Indexed: 12/31/2022] Open
Abstract
miR-146a has been implicated in the regulation of the immune response as well as in inflammatory process of atherosclerosis. In the present study, we have investigated the expression of miR-146a and its targets, TLR4 a IRAK1, in aortic valve stenosis. A total of 58 patients with aortic stenosis (non- and atherosclerotic; tissue obtained during standard aortic valve replacement) were enrolled. The relative expression of mir-146a was higher in valvular tissue from patients with atherosclerosis compared to those without atherosclerosis (p = 0.01). Number of the IRAK1 and TLR4 transcripts did not differ between the investigated groups. There was a trend toward elevation of miR-146a expression in context of inflammatory infiltrate observed in the valvular tissue from patients with atherosclerosis (p = 0.06). In conclusion, in line with the acknowledged role of miR-146a in atherosclerotic inflammation, our data suggest it may be extended to the specific location of aortic valves in aortic stenosis.
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Affiliation(s)
- Jana Petrkova
- Department of Pathological Physiology, Faculty of Medicine Dentistry, Palacky University, Olomouc, Czechia.,Internal Medicine I - Cardiology, Palacky University and University Hospital, Olomouc, Czechia
| | - Jana Borucka
- Department of Pathological Physiology, Faculty of Medicine Dentistry, Palacky University, Olomouc, Czechia.,Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czechia
| | - Martin Kalab
- Department of Cardiac Surgery, Palacky University and University Hospital, Olomouc, Czechia
| | - Petra Klevcova
- Department of Pathological Physiology, Faculty of Medicine Dentistry, Palacky University, Olomouc, Czechia
| | - Jaroslav Michalek
- Department of Clinical and Molecular Pathology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czechia
| | - Milos Taborsky
- Internal Medicine I - Cardiology, Palacky University and University Hospital, Olomouc, Czechia
| | - Martin Petrek
- Department of Pathological Physiology, Faculty of Medicine Dentistry, Palacky University, Olomouc, Czechia.,Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacky University, Olomouc, Czechia.,Laboratory of Cardiogenomics, University Hospital Olomouc, Olomouc, Czechia
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Skala T, Tudos Z, Homola M, Moravec O, Kocher M, Cerna M, Ctvrtlik F, Odstrcil F, Langova K, Klementova O, Taborsky M. The impact of ECG synchronization during acquisition of left‑atrium computed tomography model on radiation dose and arrhythmia recurrence rate after catheter ablation of atrial fibrillation - a prospective, randomized study. BRATISL MED J 2019; 120:177-183. [PMID: 31023034 DOI: 10.4149/bll_2019_033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The impact of ECG gating during computed tomography (CT) acquisition of left atrium (LA) model on radiation dose, image quality and ablation event-free survival rate after catheter ablation (CA) of atrial fibrillation (AF) is not well defined. METHODS Sixty-two patients with paroxysmal atrial fibrillation were randomized for two types of LA CT (with vs without ECG gating) before CA. Pulmonary veins isolation was performed in all patients. Patients were followed for 12 months after CA. RESULTS There was no difference between the groups in CA length (131.61±32.57 vs 119.84±33.18 min; p=0.108), CA fluoroscopy time (4.48±2.19 vs 3.89±1.83 min; p=0.251), CA fluoroscopy dose (3.99±2.79 vs 3.91 vs2.91 Gy*cm2; p=0.735), visual data quality (1.77±0.88 vs 2.0±0.63; p=0.102) and registration error (2.42±0.72 vs 2.43±0.46 mm; p=0.612). We found a significant difference in CT Dose index (89.55±5.99 vs 19.19±4.33 mGy; p<0.0001) and Dose Length product (1438.87±147.75 vs 328.21±73.83 mGy*cm; p<0.0001). Twelve months after CA, 25 of 31 patients in the gated group and 24 of 31 patients in the non-gated group were free of AF (80.65 vs 77.42 %; p=0.838). CONCLUSION ECG gating of computed tomography of LA before AF ablation burdens patients with a four times higher radiation dose while improving neither the quality of CT model or fusion of CT with the electroanatomic map. As a result, it has no significant impact on arrhythmia recurrence rate after ablation (Tab. 3, Fig. 3, Ref. 25).
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Skala T, Tudos Z, Moravec O, Hutyra M, Precek J, Skalova J, Klementova O, Zapletalova J, Taborsky M. Atrial fibrillation inducibility after pulmonary vein isolation under general anaesthesia. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 164:261-266. [PMID: 30829344 DOI: 10.5507/bp.2019.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 02/25/2019] [Indexed: 01/08/2023] Open
Abstract
AIMS Atrial fibrillation (AF) inducibility with rapid atrial pacing following AF ablation is associated with higher risk of AF recurrence. The predictive value of AF inducibility in paroxysmal AF patients after pulmonary vein isolation (PVI), done under general anaesthesia (GA), remains questionable since GA might alter AF inducibility and/or sustainability. METHODS Consecutive patients (n = 120) with paroxysmal AF without prior catheter ablation (CA) were enlisted in the study. All patients were ablated under GA. We have used a point-by-point CA and elimination of dormant conduction after adenosine in all patients. A predefined stimulation protocol was used to induce arrhythmias after PVI. Regular supraventricular tachycardias were mapped and ablated. Patients were divided into 3 subgroups - noninducible, inducible AF with spontaneous termination in five minutes, inducible AF without spontaneous termination. During 12 months of follow-up, all patients were examined four-times with 7-day ECG recordings. RESULTS There was no statistical difference between the three subgroups in a rate of arrhythmia recurrence (11.1 vs. 27.5 vs. 27.3%, P=0.387), despite a clear trend to a better success rate in the non-inducible group. The subgroups did not differ in left atrial (LA) diameter (41.0±6, 43.0±7, 42.0±5 mm, P=0.962) or in any other baseline parameter. CONCLUSION AF inducibility as well as presence or absence of its early spontaneous termination after PVI done under general anaesthesia in paroxysmal AF patients were not useful as predictors of procedural failure.
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Affiliation(s)
- Tomas Skala
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Zbynek Tudos
- Department of Radiology, University Hospital Olomouc, Czech Republic
| | - Ondrej Moravec
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jitka Skalova
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Czech Republic
| | - Olga Klementova
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Czech Republic
| | - Jana Zapletalova
- Department of Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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Skala T, Precek J, Hutyra M, Moravec O, Tudos Z, Skalova J, Klementova O, Antonicka A, Zapletalova J, Taborsky M. Long-term outcome of paroxysmal atrial fibrillation catheter ablation with and without pulmonary vein dormant conduction after adenosine challenge. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 164:147-153. [PMID: 30829343 DOI: 10.5507/bp.2019.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 02/26/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The prognostic significance of adenosine-mediated pulmonary vein (PV) dormant conduction is unclear. We prospectively followed patients with adenosine-mediated PV reconduction with a subsequent repeated ablation until there was no reconduction inducible with patients without reconduction after PV isolation. METHOD AND RESULTS Consecutive patients (n=179) with paroxysmal atrial fibrillation (AF) without prior catheter ablation (CA) were enlisted in the study. We used a point-by-point CA and general anesthesia in all patients. Twenty minutes after PV isolation we administered adenosine in a dose sufficient to produce an atrioventricular block. If a dormant conduction was present (n=54) we performed additional ablation until there was no adenosine mediated reconduction inducible. During 36 months of follow-up, all patients were examined for eight 7-day ECG recordings. There was no difference in arrhythmia recurrence rate between patients with and without dormant conduction (29.6 vs. 24.8% at 12 months, P=0.500; 31.5 vs. 30.4% at 36 months, P=1.000), for any echocardiographic parameter or any parameter of the ablation procedure. CONCLUSION The patients with dormant conduction after adenosine during catheter ablation of paroxysmal atrial fibrillation with complete elimination of the dormant conduction by additional extensive ablation have the same outcome in the long term as patients without a dormant conduction.
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Affiliation(s)
- Tomas Skala
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jan Precek
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Martin Hutyra
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Ondrej Moravec
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Zbynek Tudos
- Department of Radiology, University Hospital Olomouc, Czech Republic
| | - Jitka Skalova
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Czech Republic
| | - Olga Klementova
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Czech Republic
| | - Andrea Antonicka
- Cardiovascular Center, Tomas Bata County Hospital, Zlin, Czech Republic
| | - Jana Zapletalova
- Department of Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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Zemanek D, Januska J, Honek T, Kubanek M, Taborsky M, Linhart A. PREVALENCE OF FABRY DISEASE IN A NATION-WIDE SCREENING PROGRAM OF MALES WITH HYPERTROPHIC CARDIOMYOPATHY. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31467-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Taborsky M, Skala T, Kocher M, Fedorco M. Extraction of a dislocated leadless pacemaker in a patient with infective endocarditis and repeated endocardial and epicardial pacing system infections. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:85-89. [DOI: 10.5507/bp.2018.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/13/2018] [Indexed: 11/23/2022] Open
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Plasek J, Taborsky M. Subclinical atrial fibrillation - what is the risk of stroke? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 163:107-113. [PMID: 30631210 DOI: 10.5507/bp.2018.083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/19/2018] [Indexed: 01/31/2023] Open
Abstract
Atrial fibrillation is the most common arrhythmia and as such, it has become a significant public health issue due to its impact on patient morbidity and mortality. The prevalence of atrial fibrillation (AF) almost doubled in the last decade, being currently 2% in unselected patient populations. Its occurrence varies with age (present in almost 20% of octogenarians) and concomitant diseases. The most prevalent concomitant diseases are hypertension, diabetes, heart failure, renal failure, and cognitive decline. Cognitive decline or stroke may be actually the first manifestation of undiagnosed atrial fibrillation. In the majority of cases, atrial fibrillation is more of a syndrome than a disease in itself, with a multitude of etiologic factors and mechanisms. The risk of cardioembolic stroke increases with the number of comorbidities and age. The overall age-adjusted risk of stroke in patients with atrial fibrillation is 5 times higher than in the general population. Nowadays, the detection of asymptomatic episodes of atrial fibrillation by cardiac electronic implantable devices (CIED), referred to as device detected or subclinical atrial fibrillation, has opened new frontiers in AF management. The risk of stroke and subsequent need for anticoagulation treatment in this group of patients with device detected AF is however not clear. Here, we will review the literature to determine the association of subclinical atrial fibrillation with the risk of stroke.
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Affiliation(s)
- Jiri Plasek
- Deptartment of Cardiovascular Medicine, University Hospital Ostrava, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic Corresponding author: Jiri Plasek, e-mail
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Pavlu L, Kocourkova L, Taborsky M, Petrkova J. Ventricular tachycardia: a presentation of Fabry disease case report. Eur Heart J Case Rep 2018; 3:yty154. [PMID: 31020230 PMCID: PMC6439386 DOI: 10.1093/ehjcr/yty154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 11/20/2018] [Indexed: 11/13/2022]
Abstract
Background Fabry disease is an inherited rare metabolic disease caused by mutation in the GLA gene, encoding lysosomal enzyme alpha-galactosidase A. The disorder is a systemic disease that manifests as cerebrovascular and cardiac disease, chronic renal failure, skin lesion, peripheral neuropathy, and other abnormalities. Ventricular tachycardia as a Fabry disease presentation is very rare. Case summary A 36-year-old man self-presented to a general practitioner complaining of episodes of shortness of breath together with a 6-month history of malaise. The 12-lead electrocardiogram (ECG) prompted a decision to transfer him immediately to a percutaneous coronary intervention (PCI) capable hospital under the suspicion of acute coronary syndrome. Whilst awaiting transport, he experienced acute onset of dyspnoea together with non-specific chest heaviness. A repeat ECG monitor strip showed ventricular tachycardia transforming to ventricular fibrillation. The patient was successfully defibrillated. Coronary angiography was performed upon arrival at hospital and demonstrated unobstructed coronary arteries. Transthoracic echocardiography revealed concentric left ventricular hypertrophy (LVH) and normal systolic function, with severe diastolic dysfunction. Magnetic resonance imaging (MRI) confirmed the LVH, and did not demonstrate any late gadolinium enhancement. Discussion Our case illustrates the pivotal role of critical clinical thinking in the diagnosis of rare but treatable hereditary cardiomyopathy. The uncommon cardiac presentation of Fabry disease promotes further research linking different phenotypes of Fabry disease with different pathogenic mutations.
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Affiliation(s)
- Ludek Pavlu
- Department of Internal Medicine-Cardiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Lenka Kocourkova
- Department of Pathological Physiology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic.,Laboratory of Cardiogenomics-LEM, University Hospital Olomouc, Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine-Cardiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
| | - Jana Petrkova
- Department of Internal Medicine-Cardiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic.,Department of Pathological Physiology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic.,Department of Medical Genetics, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic
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Kratky V, Kopkan L, Kikerlova S, Huskova Z, Taborsky M, Sadowski J, Kolar F, Cervenka L. The Role of Renal Vascular Reactivity in the Development of Renal Dysfunction in Compensated and Decompensated Congestive Heart Failure. Kidney Blood Press Res 2018; 43:1730-1741. [DOI: 10.1159/000495391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 11/14/2018] [Indexed: 11/19/2022] Open
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Griva M, Stastny J, Kopriva P, Slabak M, Coufal Z, Jarkovsky J, Svoboda M, Salek T, Sukupova L, Taborsky M. Selective coronary angiography, percutaneous coronary intervention and asymptomatic peri-procedural myocardial injury. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018; 163:324-330. [PMID: 30398220 DOI: 10.5507/bp.2018.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 10/15/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND While there have been a number of studies reporting the incidence and implications of elevated troponin levels after percutaneous coronary intervention (PCI), the body of information about the incidence, associations, and implications of elevated troponin levels following coronary angiography (CAG) is limited. MATERIALS AND METHODS A total of 220 consecutive patients with stable coronary artery disease or intermediate or low-risk acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS) were included in our study. High-sensitivity cardiac troponin I (hs-cTnI) levels were measured before and after coronary angiography (CAG) in patients with or without PCI and correlated with a number of clinical variables. RESULTS Hs-cTnI elevations above the 99th percentile upper reference limit (URL), or above 20% of the initially positive, yet already declining values, were found in 60 (37.2%) patients after CAG and in 45 (76.2%) patients undergoing PCI. Significant correlations of hs-cTnI elevation were found with the following variables: volume of contrast, fluoroscopy time, dose-area product, amount of contrast agent injected directly into the coronary arteries, total time of balloon dilation and the number and total length of implanted stents (P<0.001 for all). CONCLUSION While an asymptomatic elevation of hs-cTnI is a common finding after PCI, it does occur, quite surprisingly, also after CAG. Despite contradictory views regarding the clinical relevance of asymptomatic post-procedural elevated hs-cTnI levels, it is generally believed that a mild elevation is not associated with an increased risk. Still, it may pose a diagnostic quandary following a successful interventional procedure and even more so after an uncomplicated CAG. TRIAL REGISTRATION Clinicaltrials.gov - NCT02960321.
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Affiliation(s)
- Martin Griva
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic.,Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jiri Stastny
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Petr Kopriva
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Martin Slabak
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Zdenek Coufal
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Tomas Salek
- Department of Clinical Biochemistry, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Lucie Sukupova
- Department of the Director, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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Lazarova M, Lazar D, Malek F, Vaclavik J, Taborsky M, Ignaszewski A. Heart failure disease management program, its contribution to established pharmacotherapy and long-term prognosis in real clinical practice - retrospective data analysis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018; 163:318-323. [PMID: 30305762 DOI: 10.5507/bp.2018.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 09/21/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIMS The prognosis of patients with heart failure (HF) is still generally unfavorable. HF with reduced ejection fraction (HFrEF) patients reach target medication doses in very low percentages in daily clinical practice. HF disease management programs (DMP), including nurse and telemedicine support that facilitate achieving target medication doses, may improve the unfavorable prognosis. METHODS We retrospectively analyzed the data of 738 patients with HFrEF who were followed in a single HF center during the years 1975-2011, for 6.4 (median) years. DMP, nurse and telemedicine support is established at this center. RESULTS The group achieved left ventricle (LV) recovery after the HF treatment. The median LV ejection fraction improved from 25.0% at baseline to 50.0% at the time of the latest data collection. The proportion of NYHA II, III and IV classes decreased from 27.6%, 30.2% and 29.7% to 26.6%, 7.2% and 0.1%, respectively while the proportion of NYHA class I increased from 12.5% to 66.1%. Median NT-proBNP decreased from 975.0 to 324.0 pg/mL. The survival of the patient group was favorable; 79.7% survived 18.1 years after diagnosis of HF. A high percentage of the patients received recommended target or higher than target doses of angiotensin-converting enzyme inhibitors (82.0%) and beta-blockers (78.1%). CONCLUSION The established pharmacotherapy resulted from an effective DMP and this contributed to the favorable prognosis.
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Affiliation(s)
- Marie Lazarova
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Dusan Lazar
- Department of Biophysics, Faculty of Science, Palacky University Olomouc, Czech Republic
| | - Filip Malek
- Heart Failure Centre, Hospital Na Homolce, Prague, Czech Republic
| | - Jan Vaclavik
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Andrew Ignaszewski
- Department of Cardiology, Heart Function Clinics, St. Paul´s Hospital, Vancouver, Canada
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Zabel M, Sticherling C, Willems R, Lubinski A, Bauer A, Bergau L, Braunschweig F, Brugada J, Brusich S, Conen D, Cygankiewicz I, Flevari P, Taborsky M, Hansen J, Hasenfuß G, Hatala R, Huikuri HV, Iovev S, Kääb S, Kaliska G, Kasprzak JD, Lüthje L, Malik M, Novotny T, Pavlović N, Schmidt G, Shalganov T, Sritharan R, Schlögl S, Szavits Nossan J, Traykov V, Tuinenburg AE, Velchev V, Vos MA, Willich SN, Friede T, Svendsen JH, Merkely B. Rationale and design of the EU-CERT-ICD prospective study: comparative effectiveness of prophylactic ICD implantation. ESC Heart Fail 2018; 6:182-193. [PMID: 30299600 PMCID: PMC6351896 DOI: 10.1002/ehf2.12367] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 08/30/2018] [Indexed: 01/10/2023] Open
Abstract
Aims The clinical effectiveness of primary prevention implantable cardioverter defibrillator (ICD) therapy is under debate. The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU‐CERT‐ICD) aims to assess its current clinical value. Methods and results The EU‐CERT‐ICD is a prospective investigator‐initiated non‐randomized, controlled, multicentre observational cohort study performed in 44 centres across 15 European Union countries. We will recruit 2250 patients with ischaemic or dilated cardiomyopathy and a guideline indication for primary prophylactic ICD implantation. This sample will include 1500 patients at their first ICD implantation and 750 patients who did not receive a primary prevention ICD despite having an indication for it (non‐randomized control group). The primary endpoint is all‐cause mortality; the co‐primary endpoint in ICD patients is time to first appropriate shock. Secondary endpoints include sudden cardiac death, first inappropriate shock, any ICD shock, arrhythmogenic syncope, revision procedures, quality of life, and cost‐effectiveness. At baseline (and prior to ICD implantation if applicable), all patients undergo 12‐lead electrocardiogram (ECG) and Holter ECG analysis using multiple advanced methods for risk stratification as well as detailed documentation of clinical characteristics and laboratory values. Genetic biobanking is also organized. As of August 2018, baseline data of 2265 patients are complete. All subjects will be followed for up to 4.5 years. Conclusions The EU‐CERT‐ICD study will provide a necessary update about clinical effectiveness of primary prophylactic ICD implantation. This study also aims for improved risk stratification and patient selection using clinical and ECG risk markers.
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Affiliation(s)
- Markus Zabel
- Department of Cardiology and Pneumology, Heart Center, University Medical Center, Göttingen, Germany.,DZHK (German Center for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | | | - Rik Willems
- Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Andrzej Lubinski
- Department of Cardiology, Medical University of Lodz (MUL) WAM Hospital, Lodz, Poland
| | - Axel Bauer
- Department of Cardiology, Klinikum Großhadern, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Leonard Bergau
- Department of Cardiology and Pneumology, Heart Center, University Medical Center, Göttingen, Germany
| | | | - Josep Brugada
- IDIBAPS, Department of Cardiology, Hospital Clinic Barcelona, Barcelona, Spain
| | - Sandro Brusich
- Department of Cardiovascular Disease, KBC Rijeka, Rijeka, Croatia
| | - David Conen
- Department of Cardiology, University Hospital, Basel, Switzerland.,Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Iwona Cygankiewicz
- Department of Electrocardiology, Medical University of Lodz (MUL), Lodz, Poland
| | - Panagiota Flevari
- 2nd Department of Cardiology, Attikon University Hospital, Athens, Greece
| | - Milos Taborsky
- Department of Cardiology, University Hospital, Olomouc, Czech Republic
| | | | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, Heart Center, University Medical Center, Göttingen, Germany.,DZHK (German Center for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Robert Hatala
- Slovak Medical University NUSCH, Bratislava, Slovakia
| | - Heikki V Huikuri
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Svetoslav Iovev
- Department of Cardiology, St. Ekaterina University Hospital, Sofia, Bulgaria
| | - Stefan Kääb
- Department of Cardiology, Klinikum Großhadern, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | | | - Jaroslaw D Kasprzak
- Chair and Department of Cardiology, Bieganski Hospital, Medical University of Lodz (MUL), Lodz, Poland
| | - Lars Lüthje
- Department of Cardiology and Pneumology, Heart Center, University Medical Center, Göttingen, Germany
| | - Marek Malik
- National Heart and Lung Institute, Imperial College, London, UK
| | - Tomas Novotny
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
| | - Nikola Pavlović
- Department of Cardiology, KBC Sestre Milosrdnice, Zagreb, Croatia
| | - Georg Schmidt
- Med. Klinik und Poliklinik I, Technische Universität München, Klinikum rechts der Isar, Munich, Germany
| | | | - Rajeeva Sritharan
- Department of Cardiology and Pneumology, Heart Center, University Medical Center, Göttingen, Germany
| | - Simon Schlögl
- Department of Cardiology and Pneumology, Heart Center, University Medical Center, Göttingen, Germany
| | | | - Vassil Traykov
- Department of Cardiology, Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria
| | - Anton E Tuinenburg
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Vasil Velchev
- Department of Cardiology, St. Anna Hospital, Sofia, Bulgaria
| | - Marc A Vos
- Department of Medical Physiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tim Friede
- DZHK (German Center for Cardiovascular Research), partner site Göttingen, Göttingen, Germany.,Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Jesper Hastrup Svendsen
- Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Béla Merkely
- Department of Cardiology, Semmelweis University Heart Center, Budapest, Hungary
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Tudos Z, Skala T, Homola M, Moravec O, Taborsky M, Kocher M, Cerna M, Ctvrtlik F, Odstrcil F, Langova K, Klementova O. ECG non-gated multi-detector computed tomography protocol prior to catheter ablation of atrial fibrillation provides sufficient data quality with lower radiation exposure compared to ECG-gated protocol - results of a prospective, randomized and blinded study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018; 162:310-318. [PMID: 30181665 DOI: 10.5507/bp.2018.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The role of ECG-gating in left atrium (LA) computed tomography (MDCT) imaging is not precisely defined. METHODS AND RESULTS 62 patients were randomized according to ECG gating with prospective evaluation of image quality, Volume CT Dose Index, Dose Length Product, Effective Dose and registration error between anatomical map and MDCT. We found significant difference in all radiation variables, but not in visual quality, registration error, CA duration, CA fluoroscopy time and CA fluoroscopy dose. CONCLUSION Helical non-gated MDCT achieved a radiation dose more than four times lower with comparable image quality and course of ablation compared to ECG-gated protocol.
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Affiliation(s)
- Zbynek Tudos
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Tomas Skala
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Martin Homola
- Department of Medical Physics and Radiation Protection, University Hospital Olomouc, Czech Republic
| | - Ondrej Moravec
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Martin Kocher
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Marie Cerna
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Filip Ctvrtlik
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
| | - Frantisek Odstrcil
- Department of Radiology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
- Department of Radiological Methods, Faculty of Health Sciences, Palacky University Olomouc, Czech Republic
| | - Katerina Langova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Olga Klementova
- Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
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Taborsky M, Fedorco M, Skala T, Novak M, Kozak M, Krivan L, Jarkovsky J. P3881Long-term outcome of patients with bacterial endocarditis after endovasal CIEDs lead extraction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - M Fedorco
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - T Skala
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - M Novak
- St. Anne's University Hospital, Ist Internal Cardiology Angiology Clinic, Brno, Czech Republic
| | - M Kozak
- University Hospital Brno, 1st Dept of Internal Medicine-Cardiology, Brno, Czech Republic
| | - L Krivan
- University Hospital Brno, 1st Dept of Internal Medicine-Cardiology, Brno, Czech Republic
| | - J Jarkovsky
- Institute of Biostatistics and Analyses of Masaryk University, IBA, Brno, Czech Republic
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Taborsky M, Cervenka L, Kopkan L, Tonar Z, Richter D, Mrazova I, Herman A. 1417Evaluation of later morphologic alterations in renal artery wall and nerves in response to catheter-based renal denervation in sheep: comparison of the single-point and multiple-point RDN catheters. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - L Cervenka
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - L Kopkan
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Z Tonar
- Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic, Department of Histology and Embryology and Biomedical Center, Plzen, Czech Republic
| | - D Richter
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - I Mrazova
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - A Herman
- Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
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Precek J, Hutyra M, Jarkovsky J, Snehota M, Kovacik F, Taborsky M. P5568Prognostic value of markers of renal function ani inflammation in early prediction of hospital mortality and major cardiac adverse events in patients with ST elevation myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- J Precek
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I-Cardiology, Olomouc, Czech Republic
| | - M Hutyra
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I-Cardiology, Olomouc, Czech Republic
| | - J Jarkovsky
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czech Republic
| | - M Snehota
- Palacky University, Faculty of Medicine and Dentistry, Department of Medical Biophysics, Olomouc, Czech Republic
| | - F Kovacik
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I-Cardiology, Olomouc, Czech Republic
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine I-Cardiology, Olomouc, Czech Republic
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46
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Spacek M, Hutyra M, Vindis D, Precek J, Sanak D, Kral M, Cechakova E, Littnerova S, Adam T, Hudec S, Taborsky M. P4561Relevance of N-terminal fragment of brain natriuretic peptide in prediction of new cerebral infarcts in acute pulmonary embolism. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Spacek
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
| | - M Hutyra
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
| | - D Vindis
- Palacky University, Faculty of Medicine and Dentistry, Department of Cardiac Surgery, Olomouc, Czech Republic
| | - J Precek
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
| | - D Sanak
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czech Republic
| | - M Kral
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czech Republic
| | - E Cechakova
- Palacky University, Faculty of Medicine and Dentistry, Department of Radiology, Olomouc, Czech Republic
| | - S Littnerova
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czech Republic
| | - T Adam
- Palacky University, Faculty of Medicine and Dentistry, Department of Clinical Biochemistry, Olomouc, Czech Republic
| | - S Hudec
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
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Skala T, Tudos Z, Hutyra M, Moravec O, Kocher M, Klementova O, Taborsky M. P1909The impact of ECG synchronization during acquisition of left atrium computed tomography model on radiation dose and arrhythmia recurrence rate after catheter ablation of atrial fibrillation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Skala
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - Z Tudos
- Palacky University, Faculty of Medicine and Dentistry, Department of Radiology, Olomouc, Czech Republic
| | - M Hutyra
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - O Moravec
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
| | - M Kocher
- Palacky University, Faculty of Medicine and Dentistry, Department of Radiology, Olomouc, Czech Republic
| | - O Klementova
- Palacky University, Faculty of Medicine and Dentistry, Department of anesthesiology and resuscitation, Olomouc, Czech Republic
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, 1st Dept of Internal Medicine-Cardiology, Olomouc, Czech Republic
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Spacek M, Zemanek D, Hutyra M, Sluka M, Taborsky M. Vulnerable atherosclerotic plaque - a review of current concepts and advanced imaging. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018; 162:10-17. [DOI: 10.5507/bp.2018.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/06/2018] [Indexed: 01/31/2023] Open
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Haugaa KH, Potpara TS, Boveda S, Deharo JC, Chen J, Dobreanu D, Fumagalli S, Lenarczyk R, Hernandez Madrid A, Larsen TB, Sciarrafia E, Taborsky M, Tilz RR, Pieragnoli P, Przybylski A, Dagres N. Patients’ knowledge and attitudes regarding living with implantable electronic devices: results of a multicentre, multinational patient survey conducted by the European Heart Rhythm Association. Europace 2017; 20:386-391. [DOI: 10.1093/europace/eux365] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 12/19/2017] [Indexed: 01/02/2023] Open
Affiliation(s)
- Kristina Hermann Haugaa
- Department of Cardiology and Institute for Surgical Research, Center for Cardiological Innovation, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tatjana S Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Cardiology Clinic, Clinical Centre of Serbia, Serbia
| | - Serge Boveda
- Division of Cardiology, Cardiac Arrhythmias Management Department, Clinique Pasteur, Toulouse, France
| | - Jean-Claude Deharo
- Service de Cardiologie—Hôpital Timone Adultes, 264 Rue Saint Pierre, Marseille, 13385 Cedex 05, France
| | - Jian Chen
- Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Dan Dobreanu
- Cardiology Clinic, Emergency Institute for Cardiovascular Diseases and Transplant, University of Medicine and Pharmacy, Tirgu Mures, Romania
| | - Stefano Fumagalli
- Intensive Care Unit, Geriatric Cardiology and Medicine Division, Experimental and Clinical Medicine Department, University of Florence and AOU Careggi, Florence, Italy
| | - Radoslaw Lenarczyk
- Department of Cardiology, Congenital Heart Disease and Electrotherapy, Silesian Medical University, Silesian Centre for Heart Diseases, Zabrze, Poland
| | | | - Torben Bjerregaard Larsen
- Department of Cardiology, Thrombosis & Drug Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Elena Sciarrafia
- Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden
| | - Milos Taborsky
- Department of Internal Medicine I—Cardiology, Palacký University Olomouc, Olomouc, Czech Republic
| | - Roland Richard Tilz
- University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Paolo Pieragnoli
- Unità di Aritmologia, Dipartimento Cardiotoracovascolare, University of Florence, Florence, Italy
| | - Andrzej Przybylski
- Head of the Department of Cardiology, KSW 2, Rzeszów, Poland
- Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Nikolaos Dagres
- Department of Electrophysiology, University Leipzig - Heart Center, 04289 Leipzig, Germany
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Vykoupil K, Galuszka J, Drac P, Taborsky M. Autonomic control of blood circulation in patients undergoing elective carotid endarterectomy. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2017; 162:36-39. [PMID: 29086771 DOI: 10.5507/bp.2017.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/17/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Internal carotid artery stenosis (ICAS) is associated with significantly higher risk of stroke. Autonomic function can be impaired in the presence of atheroma in the carotid sinus region. Two parameters of autonomic nervous system (ANS) function e.g. heart rate variability (HRV) and baroreflex sensitivity (BRS) are respected predictors of cardiovascular prognosis. We assessed the effect of elective unilateral carotid endarterectomy (CEA) on cardiovascular autonomic functions as a major prognostic factor for cardiovascular health. METHODS Nineteen patients indicated for CEA underwent formal autonomic assessment in the laboratory. Hemodynamic profiles, HRV and BRS were evaluated with the dedicated high-tech device Task Force Monitor before surgery (day-1) and postoperatively (day 3±1). Data were obtained during 5 min orthostatic challenge and subsequent 5 min in a supine position. RESULTS There were no significant early postoperative changes in evaluated parameters after CEA. There was a mild decrease of blood pressure and therefore only a slight increase in BRS. It was also possible to observe a rise in the value of total power and high frequency power. CONCLUSION In the early postoperative period, healing processes are occurring and the sympatho-vagal interaction is probably still unbalanced. Given the considerable clinical potential of BRS and HRV measurement, further short-term and, more importantly, long-term investigations are needed.
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Affiliation(s)
- Karel Vykoupil
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jan Galuszka
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Petr Drac
- Department of Surgery II - Vascular and Transplantation Surgery, University Hospital Olomouc, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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