(Prescription of basic pharmacotherapy and its dosage in outpatient care after discharge in patients hospitalized for cardiac decompensation)

Jan Orct, Otto Mayer Jr., Simona Bílková, Tomáš Krynský, Josef Jirák

Cor Vasa 2024, 66(4):394-402 | DOI: 10.33678/cor.2024.036  

Aims: We analyzed the prescription and dosage of essential pharmacotherapy in outpatient care at the end of 2022 in patients hospitalized between 2010-2020 for cardiac decompensation. Methods: The initial sample included 4097 patients hospitalized for cardiac decompensation. From this cohort, we analyzed 975 surviving patients (mean age 71.9 [±SD 10.8], 62.8% male) regarding pharmacotherapy in their central medication record. Results: The prescription of beta-blockers (BB) was 79.6% in outpatient care and did not significantly change after discharge from hospitalization (77.5%). Taking BB with evidence in chronic heart failure (HF) only, there...

Investigation of Heart Rate Variability and Ventricular Repolarization Indexes in Brucella Patients with Palpitations

Okan Tanriverdi, Lutfu Askin, Husna Sengul Askin, Serdar Turkmen

Cor Vasa 2024, 66(4):403-410 | DOI: 10.33678/cor.2024.016  

Background: Global zoonotic diseases like brucellosis increase cardiac mortality and malignant arrhythmias. Heart rate variability (HRV) measures heart rate non-invasively and reliably. Lower HRV suggests autonomic dysfunction. The Tp-e/QT interval (QT) and corrected QT (QTc) ratios are used to detect ventricular arrhyth- mogenesis. Objective: In brucellosis, we examined the relationship between autonomic dysfunction and ventricular repolarization (VR). This was done noninvasively by assessing HRV and VR parameters. Methods: One hundred patients with brucellosis had a mean age of 39.2±1.1 years. One hundred healthy volunteers with a mean age of...

Baseline intervals in electrocardiogram for risk stratification in Brugada syndrome: A 10-year prospective study

Vanda Devesa Neto, Joana Correia, António Costa, Luís Santos

Cor Vasa 2024, 66(4):411-416 | DOI: 10.33678/cor.2024.027  

Background: Risk stratification in Brugada syndrome (BrS) remains challenging. The aim of this study was to evaluate the baseline intervals in resting ECG of a cohort of Portuguese patients with first-degree relatives diagnosed with BrS and to identify ECG parameters associated with cardiac events (CE) over a 10-year period. Methods: Prospective study assessing 107 Portuguese patients with first-degree relatives diagnosed with BrS and followed over a decade to detect CE. Subgroups included spontaneous type 1 (SB), inducible type 1 (IB), and normal ECG. CE were a composite endpoint comprising of sudden cardiac death (SCD), implantable cardioverter-defibrillator...

Heart Rate Recovery Index Evaluation in Prediabetic Patients

Okan Tanriverdi

Cor Vasa 2024, 66(4):417-420 | DOI: 10.33678/cor.2024.046  

Background: Prediabetes is a major public health risk factor for type 2 diabetes. The heart rate recovery index (HRRI) shows autonomic function and predicts cardiovascular disease (CVD) independently. The objective of the research was to assess the HRRI in individuals with prediabetes. Methods: The study comprised 400 cardiology clinic patients, 164 (41% female) and 316 (59% male). The Bruce protocol required treadmill stress ECGs for all patients. After the stress test, HRRIs were collected at 1, 2, 3, and 5 minutes. HRRI is calculated by subtracting the subject's maximal exercise HR at the end of the session from HR after 1, 2, 3, and 5 minutes of...

(Non-invasive evaluation of myocardial work efficiency: from theory to practice)

Tereza Hadžić, Olena Iurchenko, Jan Kovanda, Michal Vrbík, Miroslav Ložek, Jan Janoušek

Cor Vasa 2024, 66(4):421-428 | DOI: 10.33678/cor.2024.030  

Ventricular function is a fundamental parameter in clinical practice when it comes to prognosis, indication for treatment, and evaluation of effectiveness of applied therapy in a variety of cardiovascular diseases. Even though there already exists a whole range of invasive and non-invasive methods of its evaluation, all these methods have their limitations. One of the possible means of evaluation of ventricular function is the measurement of myocardial work which enables to assess myocardial work efficiency if related, for example, to cardiac output. This has, however, required performing an invasive study in the past. Recently, a new method of myocardial...

(Atrial fibrillation in patients with hypertrophic cardiomyopathy)

Veronika Puchnerová, Michael Jenšovský, Petr Ošťádal, Jiří Bonaventura

Cor Vasa 2024, 66(4):429-434 | DOI: 10.33678/cor.2024.038  

Atrial fibrillation is the most common sustained arrhythmia in patients with hypertrophic cardiomyopathy. The review article focuses on the complex mechanisms of development of atrial fibrillation in this subgroup of patients and on specific aspects of treatment (anticoagulation therapy and rhythm control). The final part focuses on the arrhythmia's effect on clinical symptomatology and prognosis of patients with hypertrophic cardiomyopathy.

Lymphomyokinetic exercises and activities for treatment of lower limb lymphedema: review

Jose Maria Pereira de Godoy, Henrique Jose Pereira de Godoy, Maria de Fatima Guerreiro Godoy

Cor Vasa 2024, 66(4):436-439 | DOI: 10.33678/cor.2024.043  

There is a scarcity of studies on active forms of muscle activity as monotherapy for the reduction in the volume of the edema. One of the major challenges is the use of an isolated method to enable the evaluation of exercises as monotherapy for an immediate and long-term reduction in edema. The only study encountered is an evaluation immediately after muscle activity. Passive exercise can reduce the edema as monotherapy, but better results are achieved when combined with compression mechanisms. The maintenance of compression after exercises or activities enables achieving better results.

(Critical comments on the document "2023 ESC Guidelines for the Management of Endocarditis")

Jiří Beneš

Cor Vasa 2024, 66(4):455-465 | DOI: 10.33678/cor.2024.053  

The article contains criticism of the 2023 ESC Guidelines for the management of endocarditis, which was published by the European Society of Cardiology in autumn 2023 and which was translated into Czech and published in the Cor et Vasa journal in spring 2024. The Guidelines contain a number of formal and factual mistakes in the field of antibiotic prophylaxis and treatment. The author of the critical comments advises Czech doctors not to accept the recommended regimens of antibiotic prophylaxis and therapy without prior consultation with the local antibiotic center or antibiotic consultant.

(Swimming induced pulmonary edema as an unusual cause of acute dyspnea)

Kateřina Gottwaldová, Marie Bulíčková, Marek Houra

Cor Vasa 2024, 66(4):440-443 | DOI: 10.33678/cor.2024.028  

Swimming induced pulmonary edema is an acute, potentially life-threatening condition that has a good prognosis with early, correct diagnosis and therapy. It affects physically active individuals, more often women, during sports activities such as swimming or diving. Clinical manifestations are sudden shortness of breath, cough, hypoxemia. Risk factors are identified, including previously undiagnosed cardiac disease. This implies the importance of preventive examinations for physically active individuals.

Bilateral Acute Limb Ischemia due to Severe Rheumatic Mitral Stenosis and Atrial Fibrillation with Neglected International Normalized Ratio Control

Muhammad Aditya, Tita Rif'atul Mahmudah, I Gde Rurus Suryawan

Cor Vasa 2024, 66(4):444-447 | DOI: 10.33678/cor.2024.039  

Acute limb ischemia (ALI) poses a critical threat to limb viability, necessitating urgent revascularization interventions. This case report discusses a 47-year-old Asian woman with bilateral ALI due to severe rheumatic mitral stenosis (MS) and atrial fibrillation (AF), with neglected international normalized ratio (INR) control. The patient presented with sudden bilateral leg pain at rest, accompanied by bluish discoloration and sensory loss. Echocardiographic findings indicated severe rheumatic MS along with a thrombus in the left atrial appendage. The computed tomography angiogram revealed a near-total thrombus originating from the upper abdominal...

Coronary Artery Fistula As An Unexpected Cause of Heart Failure: A Case Report

Andrianto, Alqi Yutha, Primasitha Maharany Harsoyo

Cor Vasa 2024, 66(4):448-451 | DOI: 10.33678/cor.2024.023  

Coronary artery fistulae (CAF) are uncommon epicardial connections between coronary vessels and either a heart chamber, known as coronary cameral fistula (CCF), or the major vessels of the heart, such as pulmonary arteries or veins. Most patients remain asymptomatic in the first two decades, thus making their presence all the more concealed. Following the third decade, occurrence of both symptoms and complications rises. The primary pathophysiological issue in coronary fistulae is believed to be the coronary steal phenomenon. The symptoms experienced are contingent on the extent of steal or shunt. We report the case of a 70-year-old man presenting...

Never Give Up: A Case Report on Transcatheter Mitral Valve Replacement by MyVal for Degenerated Mitral Bioprosthesis During Hostilities in Ukraine

Mykola Stan, Andrii Khokhlov, Oleh Zelenchuk, Borys Todurov, Natalia Ponych, Serhii Sudakevych, Stepan Maruniak

Cor Vasa 2024, 66(4):452-454 | DOI: 10.33678/cor.2024.032  

The following clinical case presents the experience of using the MyVal (Meril Life Sciences) transcatheter biological aortic valve prosthesis to eliminate severe insufficiency of a degenerated mitral valve (MV) bioprosthesis, which occurred in the context of constant military operations, related air alerts, and power outages, which complicated the logistics of this procedure.

Daniel Z. Lieberman a Michael E. Long: Dopamin. Molekula, která určuje osud lidstva

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2024, 66(4):468  

Docent MUDr. Petr Němec, CSc., MBA, oslavil 70. narozeniny

prof. MUDr. Jan Černý, CSc., MUDr. Petr Fila, Ph.D.

Cor Vasa 2024, 66(4):467