Cor et Vasa, 2023 (vol. 65), issue 3

Original research articles

(Implantation of leadless pacemaker (LP) Micra - single center experience)

Jan Boček, Markéta Segeťová, Jan Beneš, Hanka Wünschová, Kamil Sedláček, Věra Lánská, Josef Kautzner

Cor Vasa 2023, 65(3):447-453 | DOI: 10.33678/cor.2022.104

Introduction: Since beginning of cardiac pacing, implanters have been facing problems related to the weakest part of pacing system - pacing leads. Historically, there were problems with lead insulation or coating; another problem is lead or fixating helix fracture.^1,2 Infection of cardiac implantable electronic devices (CIEDs) is also a significant issue.^3,4 As a reaction to these challenges, the concept of leadless pacing was developed. In this stimulation modality, miniature pacemaker is implanted directly into cavity of right

(Endovascular treatment of abdominal aortic aneurysm with angulated neck)

Khaled El Samman, Petr Šedivý, Helena Přindišová, Alena Šnajdrová

Cor Vasa 2023, 65(3):455-459 | DOI: 10.33678/cor.2023.017

Aim: To evaluate the technical and clinical success of stent graft implantation in abdominal aortic aneurysm (AAA) with neck angulated more than 60 degrees. Methods: We retrospectively analyzed the outcomes of endovascular treatment of subrenal aortic aneurysm (EVAR) performed from 2013 to 2021 in patients with AAA neck angulation greater than 60 degrees. The cohort consists of 27 patients with neck angulation of 65-95 degrees. Results: In all 27 cases the stent graft (SG) was correctly implanted by the same endovascular team. Type I endoleak was present in 2 patients. In the first case, we managed the endoleak with proximal SG exten- sion, in the...

The impact of the cardiovascular risk factors on short-term in-hospital outcome of patients with COVID-19

Noha Hassanin Hanboly, Sameh Wadie, Reda Hussain Diab, Mohamed Omar

Cor Vasa 2023, 65(3):461-467 | DOI: 10.33678/cor.2022.095

Background: Coronavirus disease (COVID-19) has caused significant morbidity and mortality. COVID-19 is more than a respiratory illness, it had multiple systemic effects such as myocarditis, arrhythmias, and venous thromboembolism. Aim of the study: We aimed to study the frequency of cardiovascular risk factors in patients with COVID-19 and the impact of these risk factors on short-term in-hospital outcome of patients newly discovered with COVID-19. Materials and methods: Cross-sectional analytic study conducted in Egypt on 200 patients (mean age of 44.2±12.7 years old) with positive polymerase chain reaction for COVID-19 recruited from different...

The clinical and angiographic impact of intravascular ultrasound guided stenting of unprotected left main and proximal left anterior descending coronary artery. A prospective randomized controlled study in Egypt

Noha Hassanin Hanboly, Yasser Mohamed Kamel Baghdady, Mostafa Mokhtar Mostafa, Assem Abdelaziz Fahmy Hashad, Yasser Ahmed Sadek

Cor Vasa 2023, 65(3):468-476 | DOI: 10.33678/cor.2022.101

Background: Coronary angiography has some limitations in the proper assessment of coronary artery le- sions. Intravascular ultrasound (IVUS) before percutaneous coronary intervention (PCI) can identify significant stenosis, select the appropriate stent and detect complications. The study aimed to evaluate the impact of intravascular ultrasound on clinical and angiographic outcomes after revascularization by stenting for patients with unprotected left main (ULM) or proximal left anterior descending (LAD) coronary artery disease (CAD). Materials and methods: A prospective randomized controlled study that was carried on sixty patients presented with stable...

The Drugs Used in the Treatment of Supraventricular Tachycardia in Pediatrics: A Systematic Review and Meta-Analysis

Hashim Talib Hashim, Jaffer Shah, Ali Talib Hashim, Omar Abdelnasser Abdelmonem Ismail Mohamed, Mahmoud Shaban Abdeljalil, Joseph Varney

Cor Vasa 2023, 65(3):477-484 | DOI: 10.33678/cor.2022.097

Background: Supraventricular tachycardia (SVT) is an abnormally rapid heart rhythm that results from improper electrical activity in the upper part of the heart. Acute management of children presenting with SVT may be a challenge, as the exact tachycardia mechanism is often unknown. The strategy for treatment depends on the presentation and clinical status of the patient. Methodology: A systematic literature review was conducted to identify and select original research reports on supraventricular tachycardia management drugs in children and infants with no structural heart disease (all children from 1 hour to 17 years of age) in accordance with the...

Impact of invasively determined cardiac power index on survival in patients with advanced chronic heart failure

Ali Dogan, Denyan Mansuroglu, Oguz Konukoglu, Emrah Ozdemir, Mert Sarilar, Ayda Guler, Nuri Kurtoglu

Cor Vasa 2023, 65(3):485-488 | DOI: 10.33678/cor.2022.100

Background: Hemodynamic parameters have recently emerged as tools for risk stratification of heart failure patients. Cardiac power output (CPO) is an indicator of cardiac performance. Cardiac power index (CPI) is calculated by indexing CPO to body surface area. The study aimed to demonstrate the prognostic role of resting CPI in advanced chronic heart failure patients. Methods: The study included patients with advanced chronic heart failure, ejection fraction below 30%, and classes III and IV functional capacity who had had right and left heart catheterization. A total of 99 patients were enrolled, with those having left ventricular assist device (LVAD)...

Gut microbiota changes in nonalcoholic fatty liver disease and concomitant coronary artery disease

Galyna Fadieienko, Oleksiy Gridnyev, Olena Kurinna, Nataliia Chereliuk

Cor Vasa 2023, 65(3):489-495 | DOI: 10.33678/cor.2022.126

Background and the research aim: Nonalcoholic fatty liver disease (NAFLD) bears serious economic consequences for the health care system worldwide and Ukraine, in particular. Cardiovascular diseases (CVD) are the main cause of mortality in NAFLD patients. Changes in the gut microbiota composition can be regarded as a potential mechanism of CVD in NAFLD patients. The research aim was the investigation changes in major gut microbiota phylotypes, Bacteroidetes, Firmicutes, and Actinobacteria with quantification of Firmicutes/Bacteroidetes in NAFLD patients with concomitant CVD. Materials and methods: There were...

Gender differences in epidemiology and risk factors of acute coronary syndrome in Algerian patients of the Oran city: descriptive cross-sectional study

Asma Amrani-Midoun, Nadia Laredj, Taki Djebaili, Abdelkader Djelloul, Lilia Zouli, Hamid Aoumeur, Farouk Boukerche, Mourad Nachi

Cor Vasa 2023, 65(3):496-500 | DOI: 10.33678/cor.2022.114

Background and aims: The aim of this study is to determine the role of clinical, lifestyle, and behavioral characteristics on the severity of the disease according to the gender. Methods: We conducted a cross-sectional descriptive study. Results: An initial sample of 1219 patients was admitted for ACS in the cardiology service of Oran-University-Hospital-Center. The electrocardiographic results revealed that 34% of the patients had ST-segment elevation myocardial infarction (STEMI) while 66% had non-ST-segment elevation myocardial infarction (NSTEMI). In STEMI patients, the mean age was 60.87±12.20 years. STEMI patients sample included 413 patients...

The relationship between the level of soluble CD40 ligand and angiographic extent and severity of coronary artery disease

Betül Cengiz Elçioğlu, Şükrü Taylan Şahin, Evin Bozçali, Şölen Himmetoğlu, Hüsniye Yüksel

Cor Vasa 2023, 65(3):501-507 | DOI: 10.33678/cor.2022.132

Objectives: Previous studies have suggested that atherosclerosis is a chronic inflammatory disease and implicate components of the immune system in atherogenesis. The CD40 and CD40 ligand system regulates multiple phases of the humoral and cellular immune response. Soluble CD40 (sCD40) ligand especially releases from activated platelets. Platelets are involved not only in thrombosis, but also in atherosclerotic lesion formation and restenosis processes. The aim of our study is to evaluate whether there is a relationship between the level of sCD40 ligand and angiographic extent and severity of coronary artery disease (CAD) and to compare other cardiovascular...

Periprocedural myocardial injury after elective percutaneous coronary intervention in stable angina pectoris: a tertiary center experience

Mert Sarilar, Veysel Oktay, Gursu Demirci, Dogac Oksen, Vedat Sansoy

Cor Vasa 2023, 65(3):508-513 | DOI: 10.33678/cor.2022.111

Background: Periprocedural myocardial injury and its clinical significance in stable patients are still under discussion. This subject has been assessed in many studies with different definitions, thresholds, and biomarkers for years. This study aimed to determine the clinical outcomes of periprocedural myocardial injury based on latest 4th UDMI guideline definitions. Methods: 238 patients who underwent elective percutaneous coronary intervention at single center were retrospectively enrolled. Patients who developed periprocedural myocardial injury were compared with patients with normal troponin values after the procedure for clinical outcomes. Primary...

Review articles

(Current role of mechanical thrombectomy in the treatment of acute ischemic stroke)

Jan Křeček, Boris Kožnar, Jakub Sulženko, Zdenko Stelmach, Petr Widimský, Ivana Štětkářová, Tomáš Peisker, Peter Vaško, Petr Mikulenka, David Lauer, Dušan Kučera

Cor Vasa 2023, 65(3):514-524 | DOI: 10.33678/cor.2022.105

Ischemic stroke is a severe condition with a high mortality and a serious risk of permanent functional dis- ability. The treatment of acute ischemic stroke has undergone a number of major changes in recent years - from systemic thrombolysis to the wide range of current mechanical thrombectomy modalities. Studies such as MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME and others have demonstrated improved outcomes in patients with large vessel occlusion when mechanical thrombectomy was used compared with best medical treatment including systemic thrombolysis. These results have completely changed the treatment paradigm. Currently, a wide variety of endovascular...

(Current methods for measurement of arterial stiffness)

Mirela Rajčinova, David Zemánek, Lukáš Matera, Vratislav Fabián

Cor Vasa 2023, 65(3):525-528 | DOI: 10.33678/cor.2022.112

Increased arterial stiffness is an independent risk factor for cardiovascular diseases. Measuring this parameter in clinical practice is controversial. Authors of this article bring review of current methods for measuring this parameter, but also for other haemodynamic parameters such as central aortic blood pressure and augmentation index. We discuss these topics and their pathophysiological context.

Cardiac surgery and the coronavirus disease 2019 pandemic

Morad Yaser Al Mostafa, Hashim Talib Hashim, Yazeed Fawwaz Abu Ruman, Irfan Ullah, Ali Talib Hashim

Cor Vasa 2023, 65(3):529-532 | DOI: 10.33678/cor.2022.098

COVID-19 is having an impact on both infected and non-infected patients. During the outbreak period, a smaller number of patients underwent cardiac surgery. These patients experienced more symptoms, had longer procedures, and had a higher in-hospital mortality rate. While the consequences of the pandemic are not fully understood, one thing is certain; we must prepare for a possible new outbreak. Currently, the future of cardiac surgery after the pandemic is unclear as the evidence is still emerging. However, the lessons learned from these unprecedented times can be taken forward to inform future service planning. Moving forward, routine screening of...

Humanin and Cardiovascular Diseases

Lutfu Askin, Okan Tanriverdi

Cor Vasa 2023, 65(3):533-537 | DOI: 10.33678/cor.2022.057

Mitochondrial-derived peptides (MDPs) are encoded by mitochondrial DNA. MDPs include humanin, ribosomal ribonucleic acid type c (MOTS-c), and small humanin-like peptides 1-6 (SHLP1-6). In times of stress, they support mitochondrial activity and cell survival. MDPs influence cell survival, metabolism, stress response, and inflammation in vivo and in vitro. Recent research shows MDPs play a significant role in cardiovascular disease (CVD) development. In addition, possible pathogenic pathways include ischemia, reperfusion damage, fibrosis, and coronary microcirculatory dysfunction. CVD biomarkers or therapy targets, MDPs. This group...

Case reports

(PRKAG2 syndrome as a highly arrhythmogenic eventuality in the differential diagnosis of hypertrophic cardiomyopathy - an example of two families with a confirmed causative DNA variant)

Markéta Hodboďová, Alice Krebsová, Petra Peldová, Rostislav Polášek, Tomáš Roubíček

Cor Vasa 2023, 65(3):538-544 | DOI: 10.33678/cor.2022.116

Hypertrophic cardiomyopathy (HCM) affects 0.2% of the population and is the most common form of hereditary heart muscle disease in adults. The most frequent cause of HCM are changes in the genes encoding sarcomere proteins. However, up to 10% of patients are affected by another type of systemic genetic dis- ease that has myocardial hypertrophy as only one of its multi-organ manifestations. Among these diseases is PRKAG2 glycogenosis, a rare metabolic storage disorder caused by an inherited defect in the γ2 regulatory subunit of adenosine monophosphate-activated protein kinase (AMPK). In addition to skeletal muscle myopathy, it causes HCMP with...

Infective endocarditis complicated by brain embolism: a case report

Peter Snopek, Jozef Hasilla, Lukáš Patrovič, Dominik Juskanič, Jakub Benko, Matej Samoš

Cor Vasa 2023, 65(3):545-549 | DOI: 10.33678/cor.2022.129

Symptomatic neurological complications occur in 15-30% of patients with infective endocarditis. At the same time, other clinically silent cerebral embolisms occur in 35-60% of patients. Staphylococcus aureus is the pathogen that causes nervous system involvement most frequently. We report a case of a 67-year-old man with infective endocarditis following a dental procedure that manifested as spondylodiscitis and multiple brain embolization, including a brain abscess that required drainage. After six weeks of treatment with broad-spectrum antibiotics and complex supportive therapy, we discharged the patient in a satisfactory mental and somatic...

(Left-right short circuit in an adult woman between the left coronary artery and the sinus coronarius caused by a giant fistula)

Zuzana Komorová, Martin Novák, Jiří Seménka, Věra Feitová, Petr Němec, Lenka Špinarová

Cor Vasa 2023, 65(3):550-554 | DOI: 10.33678/cor.2022.078

Communication between coronary arteries and large arteries or heart cavities in the form of fistula is a rare anomaly occurring in about 0.1-1.0% of coronarographed patients. Our case report describes a 65-year-old patient admitted to our department for suspicious left-right short circuit. Transesophageal echocardiography was performed and revealed communication between the left coronary artery trunk and the coronary sinus. Coronary angiography and subsequent CT coronarography confirmed the finding of a gigantic fistula between the ACS strain and the coronary sinus. Due to the extent of the short circuit, cardiac surgery was indicated - fistula ligation...

(Popliteal artery entrapment syndrome)

Lucie Petroušová, Jakub Sulženko

Cor Vasa 2023, 65(3):555-557 | DOI: 10.33678/cor.2022.099

Popliteal artery entrapment syndrome is caused by external compression of vascular structures in the fossa poplitea. In most cases it manifests as lower extremity claudication. Early diagnosis and treatment may prevent artery damage, which would most often lead to aneurysmatic dilatation of the artery with possible onset of thrombosis and next may lead to embolization into the peripheral arteries, which would manifest as peripheral artery disease. This article is an overview of this problematics and a case report.

Anomalous origin of the left main coronary artery from the right coronary sinus of Valsalva

Rodolfo Caminiti, Giampaolo Vetta, Antonio Parlavecchio, Giuseppe Dattilo, Michele Magnocavallo, Domenico Giovanni Della Rocca, Massimo Siviglia, Francesco Antonio Benedetto

Cor Vasa 2023, 65(3):558-559 | DOI: 10.33678/cor.2022.076

A 73-year-old man underwent coronary angiography before aortic valve replacement due to severe aortic stenosis showing an abnormal origin of the left main coronary artery (LMCA). The LMCA arises from the right coronary sinus of Valsalva and passes anteriorly to the pulmonary trunk.

A multimodality imaging approach to multifocal intracardiac masses

Vanda Devesa Neto, João Miguel Santos, Luis Ferreira Santos, José Miguel Correia

Cor Vasa 2023, 65(3):560-562 | DOI: 10.33678/cor.2022.053

The authors expose a case report of a 75-year-old woman admitted due to syncope and history of endometrial sarcoma. Echocardiography at hospital admission revealed two cardiac masses (in the right atrium [32×38 mm] and the other in the left ventricle [42×32 mm]), both with mobility and causing dynamic obstruction of the tricuspid valve and left ventricular outflow tract. Metastatic lesions were promptly suspected, considering the previous history, and an approach based on multimodality cardiovascular imaging was performed for differential diagnosis. Endometrial stromal sarcomas are rare tumors of the uterus corresponding to 0.2-1% of all uterine malignancies....

Sino-atrial block due to Guillan-Barré syndrome: a rare case

Giuseppe Pelaggi, Alfredo Luongo, Francesca Parisi, Paolo Vinciguerra, Alessia Perna, Federica Cocuzza, Francesca Campanella, Alessio Currò, Lorenzo Pistelli

Cor Vasa 2023, 65(3):563-566 | DOI: 10.33678/cor.2021.100

Sino-atrial node block is a condition characterized by a slowed (or interrupted) electrical impulse transmis- sion from the sino-atrial node to the atrium.¹ The sino-atrial dysfunction potentially leads to sinusal arrest, bradycardia up to asystole, syncope and cardiac arrest. In such situations, a temporary or permanent pacemaker implantation is necessary. Different causes may be responsible for sinus atrial block, more frequently vagal hypertone, ions alterations, myocarditis and iatrogenic causes.^2-9 We report the case of a sixty-year-old man with Guillain-Barré syndrome who required pacemaker implantation for II to III degree...