Cor et Vasa, 2021 (vol. 63), issue 3

Original research articles

Right ventricular systolic and diastolic function in heart failure with preserved ejection fraction

Noha Hassanin Hanboly, Yasser Mohamed Baghdady, Sameh Mohamed Helmy El-Kaffas, Tamer Ashraf Hassanien Mohamed

Cor Vasa 2021, 63(3):295-303 | DOI: 10.33678/cor.2020.022

Background: Heart failure (HF) with preserved ejection fraction (EF) has recently become an important health problem. It has been established as a major cause of cardiovascular morbidity and mortality. In heart failure with reduced ejection fraction right ventricular dysfunction is common and is associated with impaired functional capacity and poor prognosis. Aim: The aim of this work was to study the right ventricular systolic and diastolic functions in patients with heart failure and preserved left ventricular ejection fraction. Methods: We included fifty patients with heart failure with preserved ejection fraction (HFpEF), "diastolic heart failure"...

CHA₂DS₂-VASc and HAS-BLED scores are not associated with cardiac defibrillators therapies

Yakup Alsancak, Hasan Sari, Ahmet Seyfeddin Gurbuz, Ahmet Lutfi Sertdemir, Alpay Aribas, Ahmet Soylu

Cor Vasa 2021, 63(3):304-311 | DOI: 10.33678/cor.2021.058

Aim: The CHA₂DS₂-VASc (heart failure, hypertension, age >75, diabetes mellitus, stroke history, vascular disease, 65-74 age range, gender) and HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleed- ing history, labile INR, elderly, drugs/alcohol) are scoring system for using to estimate stroke and bleeding development in cases with atrial fibrillation. We aim to evaluate the relationship between the implantable cardioverter defibrillator (ICD) therapies and CHA₂DS₂-VASc and HAS-BLED scores. Methods: 398 patients were included in this retrospective study after reviewing the data of...

Prevalence of post-procedural pain and associated factors experienced after transradial coronary angiography

Murat Gul, Burak Acar, Ozlem Karabulut, Mustafa Karanfil, Sefa Unal, Cagri Yayla, Ahmet Goktug Ertem, Ilke Erbay, Derya Tok, Burcu Demirkan, Ayca Ozdemir, Halil Lutfi Kisacik

Cor Vasa 2021, 63(3):312-317 | DOI: 10.33678/cor.2020.099

Introduction: Coronary angiography is a principle diagnostic and therapeutic procedure in modern cardiology practice. The transradial access for cardiac catheterization has overtaken the transfemoral approach because of many advantages. However, some patients suffer radial pain after the procedure. Unfortunately, this complication has been poorly evaluated in previous studies. The present study aimed to determine the prevalence of radial pain after transradial coronary angiography and investigate factors that influence post-procedural pain. Methods: This is a cross-sectional study in which a total of 100 consecutive patients who underwent elective...

Brachial flow-mediated vasodilatation in predicting the complexity of coronary artery disease

Wisnu Sakulat, Budi S. Pikir, Eka Prasetya Budi Mulia, Maya Qurota A'yun

Cor Vasa 2021, 63(3):318-323 | DOI: 10.33678/cor.2020.111

Goal: A number of atherosclerosis risk factors have been identified, but it remains difficult to predict how these factors interact in determining the endothelial function and development of coronary artery disease (CAD). Non-invasive assessment of endothelial function is commonly undertaken using the flow-mediated vasodilatation (FMD) technique. The use of FMD as a surrogate indicator for the complexity of CAD remains largely unknown. This study aimed to determine the correlation between FMD with the complexity of CAD based on SYNTAX score for better and simpler diagnostic tools. Methodology: This was a cross-sectional study with purposive sampling....

Individually tailored 12-week home-based exercise program improves both physical capacity and sleep quality in patients with pulmonary arterial hypertension

Līna Butāne, Matīss Šablinskis, Andris Skride, Daina Šmite

Cor Vasa 2021, 63(3):325-332 | DOI: 10.33678/cor.2020.115

Background: Most patients with optimal PAH-targeted medical therapy suffer from clinical symptoms, reduced exercise tolerance and have a poor quality of life. The 2019 European Respiratory Society task force statement on physical exercise and rehabilitation in patients with severe, chronic PH suggests that individually adjusted and monitored exercise programs are likely to be safe for PH patients, who are clinically stable on medical therapy. Currently, the development of PAH-specific rehabilitation interventions is still in the research stage. We present the preliminary results of a more extensive study with the aim to show the effectiveness of a...

Gender specific differences in functional capacity in asymptomatic patients with severe aortic stenosis

Marko Banovic, Voin Brkovic, Martin Penicka, Vladan Vukcevic, Milika Asanin, Andrea Manojlovic, Milica Bojanic, Ivana Nedeljkovic, Srdjan Aleksandric, Miodrag Jovanovic, Serge Nikolic

Cor Vasa 2021, 63(3):333-338 | DOI: 10.33678/cor.2020.107

Female gender has been linked to increased risk of adverse events after surgical aortic valve replacement but with better outcome after TAVI. Less is known regarding functional capacity between the genders with severe AS. We investigated whether there is a gender difference in functional capacity in asymptomatic group of patients with severe AS. Method: Asymptomatic patients with severe AS were prospectively enrolled and underwent cardiopulmonary exercise testing (CPET) on supine ergobicycle, ramp protocol, 15 W/min. Patients with test positive for ischemia were excluded. Results: There were 139 patients, 61 women. There were no baseline gender differences...

Microscopical assessment of explanted allograft heart valves: a limited contribution of histopathology to the pathogenic mechanism of the graft failure in long-term explants

Ondřej Fabián, Mariia Havova, Roman Gebauer, Rudolf Poruban, Ondřej Materna, Jaroslav Špatenka, Jan Burkert, Václav Chaloupecký, Vilém Rohn, Filip Mikuš, Eliška Obešlová, Jan Janoušek

Cor Vasa 2021, 63(3):339-344 | DOI: 10.33678/cor.2020.098

Background: Cryopreserved allograft heart valves (CAHV) currently represent conduits of choice showing longer event-free survival compared to other types of prostheses. However, almost all patients develop early or late allograft failure. The exact mechanism of the failure and eventual role of cellular or antibody-mediated rejection remain uncertain. In this study, we targeted the microscopical structure of CAHV in correlation to the duration of implantation, assessed the degree of degenerative changes and searched for signs of cellular rejection.Methods: 24 patients with CAHV and one patient with xenograft heart valve who required conduit explan-tation...

The secondary effect of the first wave of COVID-19 and its consequences on myocardial infarction care in a high volume Hungarian cardiovascular centre

Réka Skoda, Gábor Fülöp, Emese Csulak, Krisztina Danics, Klára Törő, Laura Bokor, György Bárczi, Béla Merkely, Dávid Becker

Cor Vasa 2021, 63(3):345-349 | DOI: 10.33678/cor.2020.101

Introduction: The high number of COVID-19 cases lean much burden on the healthcare system. Physicians report fewer acute coronary syndrome (ACS) patients presenting to hospitals in countries severely affected by the pandemic. It is concerning that patients with life-threatening illness can suffer more complications or die due to their myocardial infarction. We have limited information about ACS-care in countries less affected by the pandemic. Being Hungary one of them, we aimed to investigate the changes in myocardial infarction care in the country's biggest PCI-center. Methods: A total of 512 consecutive patients have been investigated, 396 people...

Review articles

(Sex differences in cardiac tolerance to ischemia-reperfusion injury - the role of mitochondria)

Bohuslav Ošťádal, Zdeněk Drahota, Petr Ošťádal, Jan Neckář

Cor Vasa 2021, 63(3):351-358 | DOI: 10.33678/cor.2021.023

Experimental and clinical studies have clearly demonstrated significant sex differences in myocardial structure and function under normal and pathological conditions. The best examples are significant sex differences in cardiac tolerance to ischemia-reperfusion injury: adult male hearts are more susceptible as compared to pre-menopausal female heart. The importance of these findings is documented by the increasing number of publications on this topic during the last years. Detailed cellular and molecular mechanisms, responsible for sex differences are, unfortunately, still not known; it has been stressed that estrogens are not the only factor involved....

A review of cardiovascular involvements associated with medications used to treat COVID-19 infection

Zeinab Mohseni Afshar, Arefeh Babazadeh, Alireza Janbakhsh, Masomeh Bayani, Elham Ramezani, Arezoo Salami Khaneshan, Soheil Ebrahimpour

Cor Vasa 2021, 63(3):359-363 | DOI: 10.33678/cor.2020.073

Coronavirus disease 2019 (COVID-19) pandemic has spread rapidly across the world and is introduced as a global health crisis. COVID-19 is one of the threatening pandemics in history involving many organs, includ- ing the cardiovascular system. The cardiovascular involvements, such as myocardial injury, myocarditis, acute myocardial infarction, dysrhythmias, and heart failure, have been reported in the COVID-19 patients. Currently, there is no specific antiviral treatment for COVID-19; though, some therapies such as interferon, remdesivir, ribavirin, favipiravir, and tocilizumab are being used. The medications used to treat COVID-19 may have cardiovascular...

Peripartální kardiomyopatie - review patofyziologie a klinických aspektů onemocnění

Tereza Schimerová, Miloš Kubánek

Cor Vasa 2021, 63(3):364-371 | DOI: 10.33678/cor.2020.100

Peripartum cardiomyopathy is a rare, but potentially life-threatening idiopathic form of cardiomyopathy characterized by manifestation of heart failure within the last month before or 5 months after the labour in previously healthy women when no other cause of heart failure is identified. The incidence of PPCM greatly varies geographically, most likely because of socioeconomic and genetic factors. The etiology, pathophysiology, and treatment of this rare disease are still quite poorly understood. PPCM reflects genetic predisposition and/or can be triggered by pathologic processes associated with pregnancy, such as preeclampsia, oxidative stress, and...

(Type 2 diabetes and heart failure - how to optimize cooperation of cardiologist and diabetologist)

Markéta Kubíčková, Josef Bis

Cor Vasa 2021, 63(3):373-377 | DOI: 10.33678/cor.2021.084

Heart failure and type 2 diabetes mellitus often occur together and are associated with poor prognosis and high mortality. Cardiovascular studies with SGLT2 inhibition carried out in recent years in type 2 diabetics have shown its beneficial effect on the reduction of hospitalization for heart failure. This beneficial effect demonstrated with all gliflozins (empagliflozin, dapagliflozin, canagliflozin) became the subject of further research and thus hope for the treatment of heart failure. DAPA-HF studies with dapagliflozin aimed at patients with chronic heart failure and reduced EF (HFrEF) confirmed a decrease in hospitalization for heart failure...

Guidelines

(EHRA expert consensus statement and practical guide on optimal implantation technique for conventional pacemakers and implantable cardioverter-defibrillators. Translation of the document prepared by the Czech Society of Cardiology)

Miloš Táborský, Josef Kautzner, Marián Fedorco, Karol Čurila, Hanka Wünschová, Jan Pyszko, Miroslav Novák, Milan Kozák, Martin Válek, Rostislav Polášek, Patrik Keprt, Milena Kubíčková, Jiří Plášek, Vít Gloger, Alan Bulava, Vlastimil Vančura, Tomáš Skála

Cor Vasa 2021, 63(3):396-416 | DOI: 10.33678/cor.2021.083

With the global increase in device implantations, there is a growing need to train physicians to implant pace-makers and implantable cardioverter-deﬁbrillators. Although there are international recommendations for device indications and programming, there is no consensus to date regarding implantation technique. This document is founded on a systematic literature search and review, and on consensus from an international task force. It aims to ﬁ ll the gap by setting standards for device implantation.

Case reports

Giant Pseudoaneurysm in Distal Anastomosis of Prosthetic Aorto-Femoral Bypass

Róbert Novotný, Tomáš Marada, Michal Kudla, Květoslav Lipár, Jakub Křístek, Jiří Novotný, Jiří Froněk, Libor Janoušek

Cor Vasa 2021, 63(3):378-381 | DOI: 10.33678/cor.2020.108

Introduction: Anastomotic pseudoaneurysms (APSA) are late complications of vascular reconstructions. The precise prevalence of APSA is not known, as many cases are not published in the literature. However, the rupture of APSA is associated with high morbidity and mortality. Method: The procedure was performed under full anesthesia. An incision was made in the left groin resect- ing the necrotic skin above APSA. APSA was carefully dissected, confirming the CT angiography finding of a massive thrombosed APSA arising from the distal anastomosis of the aorto-femoral bypass (AFB). The APSA was fully resected. An extension of the AFB with the use of prosthetic...

(Infective endocarditis of bicuspid aortic valve complicated by an abscess in in aortomitral continuity and intracardiac fistula)

Jitka Kůtová Stránská, Pavel Nedbal, Jan Vojáček, Tomáš Roubíček, Rostislav Polášek

Cor Vasa 2021, 63(3):382-385 | DOI: 10.33678/cor.2021.002

Infective endocarditis is a serious disease with a signiﬁ cant effect on morbidity and mortality. Patients with bicuspid aortic valve are known to be more prone to infective endocarditis. An abscess in aortomitral continuity with intracardiac ﬁ stula is a very rare and serious complication of infective endocarditis. We describe the case of a 47-year-old man with infective endocarditis complicated by an abscess and intracardiac ﬁ stula presenting with dyspnea and development of heart failure with a need for an urgent surgical solution.

(Gigantic aneurysm of the ascending aorta as the coincidental finding by patient with decompensated chronic heart failure)

Kateřina Bažantová, Kamil Novobílský, Vladimír Kaučák, Viktor Kiš

Cor Vasa 2021, 63(3):386-389 | DOI: 10.33678/cor.2020.118

In the case report the case of patient with a very well-known severe systolic dysfunction of the left ventricle is being presented. The same patient has been diagnosed with presence of the gigantic aneurysm of the aorta with signiﬁ cant regurgitation because of show symptoms of heart failure. Nowadays thanks to well-available imaging methods it is rare to diagnose the gigantic aneurysm of aorta. This disease is also uncommon cause of heart failure.

A unique case of embolic myocardial infarction in a 22-year-old woman with Fontan circulation

Marianna Vachalcová, Marta Jakubová, Martin Czerny, Alžbeta Bánovčinová, Silvia Mišíková, Allan Böhm, Karolina Angela Sieradzka, Pavol Török, Gabriel Valočik, Ingrid Schusterová

Cor Vasa 2021, 63(3):390-394 | DOI: 10.33678/cor.2020.116

Coronary artery embolism is an uncommon cause of acute myocardial infarction. We present a case of a 22-year-old patient with double inlet left ventricle (DILV), ventricular septal defect and pulmonary stenosis after Fontan repair with an acute embolic inferior ST-segment elevation myocardial infarction (STEMI). Apart from already known risk factors of thrombotic complications associated with Fontan circulation, additional predispositions in this patient included thrombus formation located in the inferior vena cava and the lack of anticoagulation therapy. This is one of the first reported embolic causes of STEMI in a patient with a Fontan circulation....