Subjects -> MEDICAL SCIENCES (Total: 8642 journals)
    - ALLERGOLOGY AND IMMUNOLOGY (218 journals)
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CARDIOVASCULAR DISEASES (338 journals)                  1 2 | Last

Showing 1 - 200 of 338 Journals sorted alphabetically
Acta Angiologica     Open Access   (Followers: 5)
Acta Cardiologica     Hybrid Journal   (Followers: 2)
Acute Cardiac Care     Hybrid Journal   (Followers: 8)
Adipositas - Ursachen, Folgeerkrankungen, Therapie     Hybrid Journal  
AJP Heart and Circulatory Physiology     Hybrid Journal   (Followers: 12)
Aktuelle Kardiologie     Hybrid Journal   (Followers: 1)
American Heart Journal     Hybrid Journal   (Followers: 60)
American Journal of Cardiology     Hybrid Journal   (Followers: 68)
American Journal of Cardiovascular Drugs     Hybrid Journal   (Followers: 17)
American Journal of Hypertension     Hybrid Journal   (Followers: 28)
Anales de Cirugia Vascular     Full-text available via subscription   (Followers: 1)
Anatolian Journal of Cardiology     Open Access   (Followers: 6)
Angiología     Full-text available via subscription  
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Angiology     Hybrid Journal   (Followers: 3)
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (Followers: 1)
Annals of Circulation     Open Access   (Followers: 2)
Annals of Noninvasive Electrocardiology     Hybrid Journal   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 12)
AORTA     Open Access  
Archives of Cardiovascular Diseases     Full-text available via subscription   (Followers: 5)
Archives of Cardiovascular Diseases Supplements     Full-text available via subscription   (Followers: 3)
Archives of Cardiovascular Imaging     Open Access   (Followers: 2)
Archivos de cardiología de México     Open Access   (Followers: 1)
Argentine Journal of Cardiology (English edition)     Open Access   (Followers: 2)
Arquivos Brasileiros de Cardiologia     Open Access   (Followers: 2)
Arrhythmia & Electrophysiology Review     Open Access   (Followers: 1)
Arteriosclerosis, Thrombosis and Vascular Biology     Full-text available via subscription   (Followers: 32)
Artery Research     Hybrid Journal   (Followers: 4)
ARYA Atherosclerosis     Open Access  
ASAIO Journal     Hybrid Journal   (Followers: 3)
ASEAN Heart Journal     Open Access   (Followers: 2)
Asian Cardiovascular and Thoracic Annals     Hybrid Journal   (Followers: 2)
Aswan Heart Centre Science & Practice Services     Open Access   (Followers: 1)
Atherosclerosis : X     Open Access  
Bangladesh Heart Journal     Open Access   (Followers: 3)
Basic Research in Cardiology     Hybrid Journal   (Followers: 10)
BMC Cardiovascular Disorders     Open Access   (Followers: 22)
Brain Circulation     Open Access   (Followers: 1)
British Journal of Cardiology     Full-text available via subscription   (Followers: 18)
Canadian Journal of Cardiology     Hybrid Journal   (Followers: 18)
Cardiac Cath Lab Director     Full-text available via subscription  
Cardiac Electrophysiology Review     Hybrid Journal   (Followers: 2)
Cardiac Failure Review     Open Access   (Followers: 1)
Cardiocore     Full-text available via subscription   (Followers: 1)
Cardiogenetics     Open Access   (Followers: 3)
Cardiology     Full-text available via subscription   (Followers: 20)
Cardiology and Angiology: An International Journal     Open Access   (Followers: 1)
Cardiology and Therapy     Open Access   (Followers: 12)
Cardiology Clinics     Full-text available via subscription   (Followers: 14)
Cardiology in Review     Hybrid Journal   (Followers: 8)
Cardiology in the Young     Hybrid Journal   (Followers: 34)
Cardiology Journal     Open Access   (Followers: 6)
Cardiology Plus     Open Access   (Followers: 1)
Cardiology Research     Open Access   (Followers: 15)
Cardiology Research and Practice     Open Access   (Followers: 10)
Cardiopulmonary Physical Therapy Journal     Hybrid Journal   (Followers: 8)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Cardiothoracic Surgeon     Open Access   (Followers: 1)
CardioVasc     Full-text available via subscription   (Followers: 1)
Cardiovascular & Haematological Disorders - Drug Targets     Hybrid Journal   (Followers: 1)
Cardiovascular & Hematological Agents in Medicinal Chemistry     Hybrid Journal   (Followers: 2)
CardioVascular and Interventional Radiology     Hybrid Journal   (Followers: 15)
Cardiovascular and Thoracic Open     Open Access  
Cardiovascular Diabetology     Open Access   (Followers: 10)
Cardiovascular Drugs and Therapy     Hybrid Journal   (Followers: 14)
Cardiovascular Endocrinology & Metabolism     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering     Hybrid Journal   (Followers: 1)
Cardiovascular Engineering and Technology     Hybrid Journal   (Followers: 1)
Cardiovascular Intervention and Therapeutics     Hybrid Journal   (Followers: 5)
Cardiovascular Journal     Open Access   (Followers: 6)
Cardiovascular Journal of Africa     Full-text available via subscription   (Followers: 5)
Cardiovascular Journal of South Africa     Full-text available via subscription   (Followers: 1)
Cardiovascular Medicine in General Practice     Full-text available via subscription   (Followers: 7)
Cardiovascular Pathology     Hybrid Journal   (Followers: 4)
Cardiovascular Regenerative Medicine     Open Access  
Cardiovascular Research     Hybrid Journal   (Followers: 15)
Cardiovascular Revascularization Medicine     Hybrid Journal   (Followers: 1)
Cardiovascular System     Open Access  
Cardiovascular Therapeutics     Open Access   (Followers: 1)
Cardiovascular Toxicology     Hybrid Journal   (Followers: 6)
Cardiovascular Ultrasound     Open Access   (Followers: 5)
Case Reports in Cardiology     Open Access   (Followers: 7)
Catheterization and Cardiovascular Interventions     Hybrid Journal   (Followers: 3)
Cerebrovascular Diseases     Full-text available via subscription   (Followers: 3)
Cerebrovascular Diseases Extra     Open Access  
Chest     Full-text available via subscription   (Followers: 103)
Choroby Serca i Naczyń     Open Access   (Followers: 1)
Circulation     Hybrid Journal   (Followers: 266)
Circulation : Cardiovascular Imaging     Hybrid Journal   (Followers: 15)
Circulation : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
Circulation : Cardiovascular Quality and Outcomes     Hybrid Journal   (Followers: 11)
Circulation : Genomic and Precision Medicine     Hybrid Journal   (Followers: 16)
Circulation : Heart Failure     Hybrid Journal   (Followers: 26)
Circulation Research     Hybrid Journal   (Followers: 36)
Cirugía Cardiovascular     Open Access  
Clínica e Investigación en Arteriosclerosis     Full-text available via subscription  
Clínica e Investigación en arteriosclerosis (English Edition)     Hybrid Journal  
Clinical and Experimental Hypertension     Hybrid Journal   (Followers: 3)
Clinical Cardiology     Hybrid Journal   (Followers: 11)
Clinical Hypertension     Open Access   (Followers: 5)
Clinical Medicine Insights : Cardiology     Open Access   (Followers: 6)
Clinical Research in Cardiology     Hybrid Journal   (Followers: 6)
Clinical Research in Cardiology Supplements     Hybrid Journal  
Clinical Trials and Regulatory Science in Cardiology     Open Access   (Followers: 4)
Congenital Heart Disease     Hybrid Journal   (Followers: 6)
Congestive Heart Failure     Hybrid Journal   (Followers: 4)
Cor et Vasa     Full-text available via subscription   (Followers: 1)
Coronary Artery Disease     Hybrid Journal   (Followers: 2)
CorSalud     Open Access  
Critical Pathways in Cardiology     Hybrid Journal   (Followers: 4)
Current Cardiology Reports     Hybrid Journal   (Followers: 7)
Current Cardiology Reviews     Hybrid Journal   (Followers: 4)
Current Cardiovascular Imaging Reports     Hybrid Journal   (Followers: 1)
Current Cardiovascular Risk Reports     Hybrid Journal  
Current Heart Failure Reports     Hybrid Journal   (Followers: 5)
Current Hypertension Reports     Hybrid Journal   (Followers: 6)
Current Hypertension Reviews     Hybrid Journal   (Followers: 6)
Current Opinion in Cardiology     Hybrid Journal   (Followers: 14)
Current Problems in Cardiology     Hybrid Journal   (Followers: 3)
Current Research : Cardiology     Full-text available via subscription   (Followers: 1)
Current Treatment Options in Cardiovascular Medicine     Hybrid Journal   (Followers: 1)
Current Vascular Pharmacology     Hybrid Journal   (Followers: 5)
CVIR Endovascular     Open Access   (Followers: 1)
Der Kardiologe     Hybrid Journal   (Followers: 2)
Echo Research and Practice     Open Access   (Followers: 2)
Echocardiography     Hybrid Journal   (Followers: 4)
Egyptian Heart Journal     Open Access   (Followers: 2)
Egyptian Journal of Cardiothoracic Anesthesia     Open Access  
ESC Heart Failure     Open Access   (Followers: 4)
European Cardiology Review     Open Access   (Followers: 1)
European Heart Journal     Hybrid Journal   (Followers: 68)
European Heart Journal - Cardiovascular Imaging     Hybrid Journal   (Followers: 10)
European Heart Journal - Cardiovascular Pharmacotherapy     Full-text available via subscription   (Followers: 2)
European Heart Journal - Quality of Care and Clinical Outcomes     Hybrid Journal  
European Heart Journal : Acute Cardiovascular Care     Hybrid Journal   (Followers: 1)
European Heart Journal : Case Reports     Open Access   (Followers: 1)
European Heart Journal Supplements     Hybrid Journal   (Followers: 8)
European Journal of Cardio-Thoracic Surgery     Hybrid Journal   (Followers: 9)
European Journal of Cardio-Thoracic Surgery Supplements     Full-text available via subscription   (Followers: 2)
European Journal of Cardiovascular Nursing     Hybrid Journal   (Followers: 5)
European Journal of Heart Failure     Hybrid Journal   (Followers: 14)
European Journal of Preventive Cardiology.     Hybrid Journal   (Followers: 6)
European Stroke Organisation     Hybrid Journal   (Followers: 3)
Experimental & Translational Stroke Medicine     Open Access   (Followers: 9)
Expert Review of Cardiovascular Therapy     Full-text available via subscription   (Followers: 3)
Folia Cardiologica     Open Access  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontiers in Cardiovascular Medicine     Open Access   (Followers: 1)
Future Cardiology     Hybrid Journal   (Followers: 6)
General Thoracic and Cardiovascular Surgery     Hybrid Journal   (Followers: 3)
Global Cardiology Science and Practice     Open Access   (Followers: 5)
Global Heart     Hybrid Journal   (Followers: 3)
Heart     Hybrid Journal   (Followers: 48)
Heart and Mind     Open Access  
Heart and Vessels     Hybrid Journal  
Heart Failure Clinics     Full-text available via subscription   (Followers: 2)
Heart Failure Reviews     Hybrid Journal   (Followers: 3)
Heart India     Open Access   (Followers: 2)
Heart International     Full-text available via subscription  
Heart Rhythm     Hybrid Journal   (Followers: 11)
Heart Views     Open Access   (Followers: 2)
HeartRhythm Case Reports     Open Access  
Hellenic Journal of Cardiology     Open Access   (Followers: 1)
Herz     Hybrid Journal   (Followers: 3)
High Blood Pressure & Cardiovascular Prevention     Full-text available via subscription   (Followers: 2)
Hypertension     Full-text available via subscription   (Followers: 23)
Hypertension     Open Access   (Followers: 2)
Hypertension in Pregnancy     Hybrid Journal   (Followers: 9)
Hypertension Research     Hybrid Journal   (Followers: 4)
Ibrahim Cardiac Medical Journal     Open Access  
IJC Heart & Vessels     Open Access   (Followers: 1)
IJC Heart & Vasculature     Open Access   (Followers: 1)
IJC Metabolic & Endocrine     Open Access   (Followers: 1)
Indian Heart Journal     Open Access   (Followers: 5)
Indian Journal of Cardiovascular Disease in Women WINCARS     Open Access  
Indian Journal of Thoracic and Cardiovascular Surgery     Hybrid Journal  
Indian Pacing and Electrophysiology Journal     Open Access   (Followers: 1)
Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery     Hybrid Journal   (Followers: 1)
Insuficiencia Cardíaca     Open Access  
Interactive CardioVascular and Thoracic Surgery     Hybrid Journal   (Followers: 7)
International Cardiovascular Forum Journal     Open Access  
International Journal of Angiology     Hybrid Journal   (Followers: 2)
International Journal of Cardiology     Hybrid Journal   (Followers: 18)
International Journal of Cardiology Hypertension     Open Access   (Followers: 1)
International Journal of Cardiovascular and Cerebrovascular Disease     Open Access   (Followers: 2)
International Journal of Cardiovascular Imaging     Hybrid Journal   (Followers: 2)
International Journal of Cardiovascular Research     Hybrid Journal   (Followers: 6)
International Journal of Heart Rhythm     Open Access  
International Journal of Hypertension     Open Access   (Followers: 8)
International Journal of Hyperthermia     Open Access  
International Journal of Stroke     Hybrid Journal   (Followers: 32)
International Journal of the Cardiovascular Academy     Open Access  
Interventional Cardiology Clinics     Full-text available via subscription   (Followers: 2)
Interventional Cardiology Review     Open Access  
JACC : Basic to Translational Science     Open Access   (Followers: 5)
JACC : Cardiovascular Imaging     Hybrid Journal   (Followers: 18)
JACC : Cardiovascular Interventions     Hybrid Journal   (Followers: 19)
JACC : Heart Failure     Full-text available via subscription   (Followers: 14)
JAMA Cardiology     Hybrid Journal   (Followers: 30)

        1 2 | Last

Similar Journals
Journal Cover
Cor et Vasa
Journal Prestige (SJR): 0.15
Number of Followers: 1  
 
  Full-text available via subscription Subscription journal
ISSN (Print) 0010-8650
Published by Elsevier Homepage  [3207 journals]
  • Catheter-induced coronary artery dissection: The role of exhalation during
           contrast medium injection
    • Abstract: Publication date: Available online 2 July 2018Source: Cor et VasaAuthor(s): Andreas Y. AndreouAbstractCatheter-induced dissection of the coronary arteries is an uncommon but potentially dreadful complication of diagnostic and interventional coronary procedures. Several risk factors have been implicated in the development of this complication; one of them is deep vigorous inhalation inducing a change in catheter position thereby contributing to catheter-induced coronary artery dissection. The present article describes a case of catheter-induced right coronary artery dissection where a change in catheter position induced by active patient exhalation contributed to the development of dissection. To the best of my knowledge this is the first case implicating active exhalation in the pathophysiology of catheter-induced coronary artery dissection.
       
  • A mobile mass on the tricuspid valve in a young female: The critical
           distinction between the vegetation and cardiac tumor
    • Abstract: Publication date: Available online 15 June 2018Source: Cor et VasaAuthor(s): Yavuzer Koza, Uğur Kaya, Enise Armağan KozaAbstractPapillary fibroelastomas (PFEs) are benign cardiac tumors with high embolic tendency, and usually originate from the cardiac valve. We report the case of a 34-year-old woman who experienced progressive dyspnea and fatigue. Transthoracic echocardiography revealed a pediculated, homogenous echo-dense, and highly mobile mass attached to the tricuspid valve. The patient was diagnosed with cardiac PFE because of its size and mobility, and surgical resection was scheduled.
       
  • Use of ultrasound guidance in vascular cannulation and effusion punctures
           at the cardiology department
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): R. Spacek, O. Jiravsky, R. Neuwirth, B. Holek, L. Sknouril, J. Hecko, M. BrannyAbstractThe use of ultrasound in cardiology for the guidance of vessel cannulations and effusion punctures is getting more and more frequent every day. Ultrasound in this setting provides the operator with many advantages and after a certain learning curve, one is then able to cannulate vessels, that are small or normally inaccessible with the standard anatomical landmarks approach. Since many randomized studies confirmed the benefits of using ultrasound in these procedures, it has become a standard of care for many physicians and hospitals.
       
  • Sexual activity and cardiovascular disease, erectile dysfunction as a
           predictor of ischemic heart disease
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): S. Hudec, M. Spacek, M. Hutyra, O. Moravec, M. TaborskyAbstractSexual activity affects the quality of life of patients with cardiovascular disease (CVD). The purpose of this document is to highlight the fact that sexual activity of patients with stable forms of CVD and moderate exercise tolerance is safe. Delaying resumption of sexual activity is not justified and could have a negative impact on the patient's mental status and the quality of partner life. Vasculogenic erectile dysfunction is considered an independent risk factor for coronary heart disease.
       
  • Echocardiography in patients with chronic kidney diseases
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Jan Malík, Vilém Danzig, Vladimíra Bednářová, Zdenka HruškováAbstractVast majority of chronic kidney disease patients die from cardiovascular complications. Echocardiography is a fundamental method, which reveals many of them. They include especially dilatation and systolic dysfunction of the left ventricle and atrium, left ventricular hypertrophy, diastolic dysfunction of the left ventricle, heart calcification, which could lead up to the development of stenotic valvular disease, right ventricular dysfunction and pulmonary hypertension. Patients with chronic kidney failure differ from the general population by cyclic changes of hydration and by the presence of a low resistant arteriovenous shunt (hemodialysis access). These factors significantly affect the actual echocardiographic finding.
       
  • Obstructive sleep apnea in outpatient care – What to do with'
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Monika Kamasová, Jan Václavík, Eva Kociánová, Miloš TáborskýAbstractObstructive sleep apnea is a relatively common sleep disorder, which is on the increase in the last decades. It significantly contributes to morbidity and mortality in all countries worldwide. Obstructive sleep apnea is one of the most common causes of daytime sleepiness. Typical risk factors for obstructive sleep apnea in the normal adult population are male gender, obesity (preferentially central obesity), and increased neck circumference, presence of manifest cardiovascular disease, diabetes mellitus, and anomalies in the upper respiratory tract. Early diagnosis and treatment improves not only the quality of life, but also significantly decreases patient morbidity and mortality. Nowadays screening can be performed in outpatient settings using simple and readily available devices. Such screening can contribute to early diagnosis and treatment of obstructive sleep apnea.
       
  • Heart failure and inhibition of renin–angiotensin–aldosterone
           system
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Jiří Vítovec, Jindřich Špinar, Lenka ŠpinarováAbstractA historical survey is presented of mortality clinical trials focussed on the inhibition of the renin–angiotensin–aldosterone system on different levels in patients with chronic heart failure. The first study, CONSENSUS, was published in 1987 and showed that the ACE-inhibitor enalapril clearly reduced mortality in severe heart failure compared with placebo. This was followed by studies with beta blockers, angiotensin II type 1 receptor blockers, blockers of mineralocorticoid receptors, and direct renin inhibitors.A recent study, PARADIGM, comparing dual inhibitor of neprilysin and antiotensin II receptor (LCZ696) with enalapril, was terminated prematurely for a significant effect of inhibiting neprilysin and valsartan.
       
  • Large vessel vasculitis
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Lucie Zavadilová, Ladislav GergelyAbstractVasculitis represents a heterogeneous group of immunopathological diseases, characterized by the inflammation of blood vessels leading to destruction of the vascular wall, subsequent proliferation and constriction, or even blockage of the lumen. According to their range, inflammatory changes cause various severe systemic manifestations such as loss of appetite, weight loss, fever of unknown origin, and night sweats; locally causing ischemia of areas supplied by the affected artery. The aim of our paper is to highlight the fact that vasculitis pose significant danger for patients, who may encounter significant delays in getting the correct diagnosis and management of their condition; and also for doctors, as vasculitis is relatively rare disease, its etiology is often unknown and pathophysiology has not been fully understood.
       
  • Low cardiovascular event rate and high atrial fibrillation recurrence rate
           one year after electrical cardioversion
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Evija Knoka, Irina Pupkevica, Baiba Lurina, Ginta Kamzola, Aldis Strelnieks, Oskars Kalejs, Aivars LejnieksAbstractBackgroundElectrical cardioversion is widely used to restore sinus rhythm in patients with atrial fibrillation. However, the long term clinical event and sinus rhythm maintenance rates following electrical cardioversion still remains unclear. This study evaluated one year incidence and risk factors for cardiovascular events and atrial fibrillation recurrence in a single center clinical practice.MethodsIn a prospective study 188 patients with atrial fibrillation who underwent electrical cardioversion were enrolled. Patients and their primary care physicians were followed up one year after cardioversion and patient clinical and arrhythmic event rate was evaluated. Data obtained from patients and general practitioners were combined and the results were analyzed with PSPP 0.8.5 software.ResultsElectrical cardioversion success rate was 90.4%. Within a year after cardioversion one patient (0.6%) suffered myocardial infarction, three patients (1.9%) had a stroke/transitory ischemic attack (TIA), three patients (1.6%) died and three patients (1.9%) had a bleeding event that required hospitalization. The presence of diabetes mellitus was the only factor with a tendency to increase the risk of combined event of myocardial infarction, stroke/TIA and bleeding (P = 0.096). At follow up 30.0% of patients reported having atrial fibrillation and within a year 62.2% had suffered at least one atrial fibrillation paroxysm. The proportion of patients who underwent additional cardioversions after the initial hospitalization was 32.5%. The factors that significantly increased the risk of atrial fibrillation recurrence were history of stroke/TIA (P = 0.014) and increased left atrial volume index on echocardiography (P = 0.039). Greater left atrial diameter had a tendency toward an increased risk (P = 0.087).ConclusionsCardiovascular event rate one year after electrical cardioversion was low. Electrical cardioversion had a high immediate success rate, however, maintenance of stable sinus rhythm in the long term was low.
       
  • Chronic heart failure – Impact of the condition on patients and the
           healthcare system in the Czech Republic: A retrospective cost-of-illness
           analysis
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Marie Pavlušová, Jiří Klimes, Jindřich Špinar, Kamil Zeman, Jiří Jarkovský, Klára Benešová, Roman Miklik, Ludmila Pohludková, Marián Felšöci, Věra Veselá, Michaela Blahovcová, Filip Dostál, Richard Vonka, Jiří PařenicaAbstractBackgroundThe number of patients with heart failure is steadily increasing, as are the costs of their treatment. Nearly 70% of the costs associated with the treatment of heart failure are direct medical costs, and 70–80% of these are spent on hospitalizations. The aim of our study is to describe the all-cause hospitalization costs of patients with chronic heart failure (chronic HF) from the perspective of the healthcare system in the Czech Republic.MethodsIn total, 1274 consecutively collected patients discharged in a stable condition from hospitalization for acute heart failure (= index hospitalization) from 2006 to 2012 were followed-up for 2 years. Their all-cause mortality and all-cause hospitalizations were retrospectively evaluated. The in-patient costs were calculated based on the relative weights of DRG codes for particular hospitalization events and on the basic DRG tariff for 2013 (CZK 28,898).ResultsAt the end of the 2-year follow-up, a total of 1511 hospitalizations were recorded. A total of 31.8% of patients survived without any hospitalization, 32.1% of patients survived with at least one hospitalization, and 36.1% of patients died. Re-hospitalizations for acute heart failure accounted for 31.2% of all cases. The average cost for one chronic HF patient hospitalized for any reason was CZK 85,414; the cost for acute heart failure re-hospitalization was CZK 31,320 during the 2-year follow-up period. The cost of all-cause hospitalizations within the first year after the index hospitalization was higher compared to the cost during the second year (CZK 58,528/year vs. CZK 23,082/year). As the estimated number of chronic HF patients is 230,000 (data from the Institute of Health Information and Statistics of the Czech Republic), we can calculate the total cost of all-cause hospitalizations of chronic HF patients to be approximately CZK 7.98 billion per year in the Czech Republic.ConclusionThe data from clinical practice confirm that patients with chronic HF discharged from acute heart failure hospitalization are at high risk of death and/or subsequent hospitalization. The average annual costs for all-cause hospitalizations of CHS patients within the first and second years are CZK 58,528 and CZK 23,082 per patient, respectively. The costs attributed to all-cause hospitalization care of chronic HF patients can be estimated as approximately 7.7% of all annual inpatient expenses of health insurance companies and 2.7% of total healthcare expenditures in the Czech Republic.
       
  • Increased dose of diuretics correlates with severity of heart failure and
           renal dysfunction and does not lead to reduction of mortality and
           rehospitalizations due to acute decompensation of heart failure; data from
           AHEAD registry
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Marie Pavlusova, Roman Miklik, Radim Spacek, Klára Benesova, Kamil Zeman, Alain Cohen-Solal, Alexandre Mebazaa, Simona Littnerova, Marian Felsoci, Lidka Pohludkova, Ladislav Dusek, Lenka Špinarova, Jiri Vitovec, Jindrich Spinar, Jiri Jarkovsky, Jiri Parenica, on behalf of GREAT NetworkAbstractBackgroundDiuretics are being used to reduce symptoms of congestion and fluid retention in heart failure patients but their effect has not been studied in randomized clinical trials. The data about positive or negative effect of loop diuretics depending on their dose is conflicting and controversial. The aim of this analysis is to evaluate whether the relatively small increase in the dose of furosemide can reduce the incidence of readmissions for acute heart failure decompensation and/or total mortality.Methods and resultsWe evaluated a total of 1119 patients admitted for ADHF who were discharged from the hospital back home in a stable condition. All surviving patients were followed up for at least two years. The primary endpoint was a combination of hospital readmissions for acute heart failure and overall mortality. The primary analysis showed significantly different characteristics and prognosis of patients who did not require any loop diuretic and those requiring furosemide dose>125 mg. Therefore, we compared a group of patients with low-dose furosemide (10–40 mg) with a group of patients with high-dose furosemide (41–125 mg) only. The higher dose of diuretics correlated well with disease severity (lower systolic blood pressure, more frequent chronic exertional dyspnea NYHA III, lower left ventricular ejection fraction, increased creatinine levels). Long-term mortality and the number of rehospitalizations were lower in the low-dose diuretic group (p = 0.037 and p = 0.036, respectively) but after adjustment using the propensity score matching the incidence of the primary endpoint was comparable in both groups.ConclusionThe dose of a loop diuretic recommended to patients with acute heart failure at hospital discharge correlates well with the severity of heart failure. When comparing the groups of patients with a higher dose of furosemide (41–125 mg) and a lower dose of furosemide (10–40 mg) we found that after adjustment using propensity score matching the higher dose of loop diuretic had a neutral effect on the incidence of the composite endpoint of overall mortality and/or readmission for ADHF.
       
  • Transition from angiotensin-converting enzyme
           inhibitor/angiotensin-II-receptor-blocker to sacubitril/valsartan in
           chronic heart failure patients: Initial experiences in clinical practice
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Katerina Hlavata, Lenka Hoskova, Janka Franekova, Antonin Jabor, Josef Kautzner, Vojtech Melenovsky, Jan BenesAbstractBackgroundSacubitril/valsartan (S/V) therapy has been demonstrated to improve prognosis of systolic heart failure (HF) patients when compared to standard therapy with ACEi. The purpose of this investigation was to document the safety and consequences of transition from ACEi/angiotensin-II receptor blocker (ARB) to S/V in chronic stable HF patients.MethodsA group of 12 stable HF outpatients (11 males, 1 female) was enrolled (NYHA 2.7 ± 0.7, 42% with coronary artery disease (CAD), average left-ventricle ejection fraction (LVEF) 26.5%). Patients were converted from ACEi/ARB to S/V. Laboratory evaluation, Minnesota Living with Heart Failure Questionnaire (MLHFQ), six-minute walk test (6MWT) were performed before the conversion and at 3-month follow-up visit.ResultsConversion from ACEi/ARB to S/V was not associated with any adverse event. After 3 months, S/V therapy decreased blood pressure (−14.8 mmHg for systolic BP, −9.6 mmHg for diastolic BP) and serum potassium (−0.27 mmol·l−1, all p 
       
  • Takotsubo cardiomyopathy in a patient with essential thrombocythemia
           treated with anagrelide: Case report
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Lenka Eremiášová, Josef Marek, Tomáš Paleček, Aleš Král, Michael Aschermann, Aleš Linhart, Vilém DanzigAbstractTakotsubo cardiomyopathy is a rare syndrome. Most often imitates acute coronary syndrome. It is characterized by transient wall motion abnormalities, especially in the apical segments of the left ventricule. Less frequently is possible to find transient akinesis or dyskinesis in the mid-ventricular segments of the left ventricule. Pathophysiological mechanisms are not completely clear. The main cause of stress cardiomyopathy is stress insult. But in rare cases can be takotsubo caused by other conditions. We reported rare case of takotsubo cardiomyopathy caused by high dose anagrelide therapy. Anagrelide is the most often used in patients with thrombocythemia. It belongs to phosphodiesterase III inhibitors and through specific pathways has certain effects on myocardium. It is the first case of takotsubo cardiomyopathy resulting from anagrelide therapy in the Czech Republic.
       
  • Composite venous allograft for femoro-pedal bypass grafting in critical
           limb ischaemia
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Miroslav Spacek, Petr Mitas, Jan Hruby, Rudolf Spunda, Pavel Měřička, Lukáš Lambert, Jaroslav LindnerAbstractBackgroundWe report a series of four patients with critical limb ischaemia and lack of autologous conduits, treated with composite (end-to-end anastomosis) allogenic fresh/or cryopreserved saphenous vein bypass grafting. This technique may be necessary in case of femoro-pedal artery bypass grafting, which is an extreme situation if there is shortage in length or inadequate quality of the venous allograft. Such a long reconstruction requires two donor saphenous veins.Case reportFour patients were indicated for “I-composite” fresh venous allograft for femoro-pedal bypass grafting. One composite graft occluded 4 months postoperatively, one 21 months postoperatively, two other remained patent with median follow-up 23 months. No amputation was required in any of the patients during the follow-up.ConclusionMidterm patency of the reconstruction may be satisfactory provided that the ABO compatibility, short cold ischaemia time of the graft, adequate immunosuppressive therapy and proper follow-up protocol of the patient after vascular allograft transplantation are observed. Surgeons should keep in mind possibility of this technique mainly in diabetic patients with critical limb ischaemia and occluded crural vessels.
       
  • Listerial myocarditis as a complication of Listerial meningoencephalitis
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): M. Strnadel, T. Hnátek, R. Havlíček, E. Krčová, M. Malý, M. ZavoralAbstractHere, we present a case report of a 53-year-old patient who was admitted for an acute ischaemic stroke. During the hospitalization period, the patient developed meningoencephalitis and acute myocarditis with recurrent episodes of ventricular fibrillation that required defibrillation repeatedly. Listeria monocytogenes was isolated from blood culture samples. The patient was treated with antibiotic therapy and showed a good clinical response. The diagnosis of myocarditis was based on the clinical and ECG presentation (ventricular arrhythmia) and elevation of troponin T level, echocardiography and MRI showed myocardial hypertrophy and pericardial effusion. In the context of this case, it is important to note that the patient suffered from scleroderma and was ambulatory treated with long-term corticosteroid therapy (Medrol 32 mg per day).
       
  • Heterogeneous aetiology and clinical presentation of cardiac involvement
           in hypereosinophilic syndrome: A case series
    • Abstract: Publication date: June 2018Source: Cor et Vasa, Volume 60, Issue 3Author(s): Martin Kotrč, Miloš Kubánek, Pavlína Malíková, Dana Kautznerová, Jacqueline Maalouf, Tereza Jančušková, Petr Lupínek, Jana Vrbská, Vojtěch Melenovský, Josef KautznerAbstractIntroductionHypereosinophilic syndrome (HES) is a heterogeneous group of diseases defined by marked hyperesonofilia (1.5 × 109/l) that persists more than 6 months with organ infiltration and damage. Cardiac involvement in HES is common and is associated with significant morbidity and mortality. To illustrate contemporary diagnostic and therapeutic methods, we reviewed three cases of HES with cardiac involvement, recently diagnosed in our institution.Description of casesWe present a series of three cases of HES with cardiac involvement and clinical presentation in the form of intracardiac thrombosis. One of these cases was caused by FIP1L1-PDGFRA positive myeloproliferation and successfully treated with imatinib. All cases received corticosteroids and oral anticoagulation with vitamin K antagonists with favourable clinical outcomes.ConclusionsAlthough HES with cardiac involvement is a rare condition, it may have severe clinical consequences and needs to be diagnosed early. Subsequent important step is careful differential diagnosis of hypereosinophilia and its targeted treatment.
       
  • Anatomical context of left anterior descending artery and right
           ventricular lead implanted apparently in the midseptal position – Case
           report
    • Abstract: Publication date: Available online 7 May 2018Source: Cor et VasaAuthor(s): Anna Mala, Pavel Osmancik, Petr Stros, Dalibor Herman, Karol Curila, Robert PetrAbstractSeptal pacing is considered to be more physiological compared to pacing of the apex of the right ventricle (RV). However, correct placement of the RV lead into the septum is often difficult using only fluoroscopic criteria during implantation; and many leads are in fact anchored in the anterior or free wall of the RV. In our case report we would like to show that unintentional implantation of the RV lead into the anterior wall can endanger left anterior descending artery, because of its close anatomical relation.
       
  • Peritoneal dialysis as successful treatment in patient with end-stage
           congestive heart failure due to endomyocardial fibrosis
    • Abstract: Publication date: Available online 27 April 2018Source: Cor et VasaAuthor(s): Francesco Sbrana, Antonio Cioni, Vladyslav Chubuchny, Claudia Taddei, Roberto Bigazzi, Emilio Maria Pasanisi
       
  • Clinical indications and time schedule for cardiac magnetic resonance
           imaging: A joint expert opinion of the Czech Society of Cardiology and
           Czech Radiological Society of the Czech Medical Society J.E. Purkyne
    • Abstract: Publication date: Available online 7 April 2018Source: Cor et VasaAuthor(s): Martin Pleva, Jiří Weichet, Tomáš Paleček, Jan Baxa, Theodor Adla, Dana Kautznerová, Šárka Bohatá
       
  • “Blue-grey syndrome” – A rare adverse effect of
           amiodarone
    • Abstract: Publication date: Available online 6 April 2018Source: Cor et VasaAuthor(s): Hana Kuncipálová, František Toušek, Hana Janatová, Jana Přádná, Miroslav ŘežábekAbstractAmiodarone is a very effective drug for some patients in cardiology, we must always consider its frequent adverse effects, which can significantly affect the quality of patients’ lives. We describe a relatively rare adverse effect of amiodarone in our case report of a 61-year-old man, who was electively admitted for implanted cardioverter defibrillator upgrade. Pronounced grey skin discolouration led us to make a diagnosis of blue-grey syndrome.
       
  • Role of serum MicroRNA-499 as a diagnostic marker in acute myocardial
           infarction (AMI)
    • Abstract: Publication date: Available online 5 April 2018Source: Cor et VasaAuthor(s): Kuzhandai Velu, R. Ramesh, R. Medha, Kulkarni Sweta, Mohammad HanifaAbstractAcute myocardial infraction is one of the leading causes of morbidity and mortality in developing countries such as India and even worldwide. Its etiology is complicated because of several confounding factors involved in its pathogenesis. Recently, MicroRNA has been recognized to play an important role in predicting the diagnosis and prognosis of myocardial infarction. MiR-499 plays a pivotal role in the recovery of cardiac cell, following injury. Since several studies have profiled several miRs in cardiovascular diseases and of which miR-499 is mainly expressed in the myocardium. Our study is primarily designed to explore the diagnostic role of miR-499 in AMI. The study included 60 AMI patients aged 30–60 years and an equal number of age and gender matched controls. All cases were taken from Mahatma Gandhi Medical College and Research Institute a tertiary healthcare setup and analyzed for miR-499 by RT-PCR, lipid profile, CK (NAC), CK-MB and high sensitivity cardiac Troponin T were analyzed by IFCC approved methods. Unpaired Student's test was performed to compare the mean of the cases with the controls. Pearson correlation was used to study the association of miR with conventional markers. Receiver Operating Characteristic curve was plotted to find out the sensitivity and specificity of miR-499 in AMI. Our study showed significantly high levels of miR499 in AMI patients in comparison to the healthy controls (p = 0.012). MiR-499 levels positively correlated with hs-cnTn T (r = 0.582, p 
       
  • Impact of the radial versus femoral access for primary percutaneous
           intervention on smoking cessation rates: A paradoxus between the health
           related quality of life and smoking quitting'
    • Abstract: Publication date: Available online 3 April 2018Source: Cor et VasaAuthor(s): Bulent Deveci, Ozcan Ozeke, Murat Gul, Burak Acar, Elif Hande Ozcan Cetin, Cengiz Burak, Serkan Cay, Serkan Topaloglu, Dursun Aras, Erdogan IlkayAbstractBackgroundSmoking cessation is potentially the most effective secondary prevention measure and improves prognosis after acute ST-segment elevation myocardial infarction (STEMI), but more than half of the patients continue to smoke after STEMI. The awareness of the disease's severity and the short hospital stay at the index STEMI have been found to be associated with persistent smoking after STEMI.ObjectiveTo assess whether the paradoxical relationship between smoking quitting rates and health-related quality of life (QOL) scores in STEMI patients undergoing primary percutaneous intervention (pPCI) by radial (RA) versus femoral approach (FA).MethodsOur population is represented by 138 STEMI patients undergoing pPCI by FA or RA. The smoking cessation rates and QOL scores were evaluated.ResultsPatients at RA group (46 patients, 57 ± 9 years, 87% male) had a higher European Quality of Life-5 Dimensions (EQ-5D) index score at post-PCI first week compared to FA group (92 patients, 57 ± 8 years, 75% male) [FA: median 0.81 (0.22) vs. RA: 1 (0.22), p = 0.042], although it was similar at baseline [FA: median 1 (0) vs. RA: 1 (0), p = 0.992]. Total hospital length of stay [RA: median 3 (1) day vs. FA: 4 (1), p 
       
  • Primary media sclerosis Mönckeberg: Diagnostic criteria
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): P. LanzerAbstractMedia sclerosis Mönckeberg (MSM) is associated with progressive calcifications of the arterial wall media leaving the intima intact. MSM is frequently associated with type 2 diabetes mellitus and chronic kidney disease. In some cases, however, no risk factors are present suggesting presence of a primary dystopic calcification disorder. Here we propose diagnostic criteria and advocate dedicated research into this as yet poorly defined vascular disorder.
       
  • The mortality benefit seen with the newer more potent oral P2Y12
           inhibitors prasugrel and ticagrelor over clopidogrel is dependent on the
           underlying risk: A class effect as suggested by a meta-regression analysis
           
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): J. Wouter Jukema, Hannes Alber, Petr WidimskýAbstractBackgroundThe two newer oral P2Y12 inhibitors prasugrel and ticagrelor have proven superior to clopidogrel in the treatment of acute coronary syndrome (ACS). The extent to which the reduction in mortality seen with ticagrelor is confined to this particular agent is hard to judge by simply looking at the overall study results as the study populations were composed of different cohorts at substantially different risk of death.MethodsA meta-regression technique was applied to 12 distinctive patient cohorts, six for each of prasugrel and ticagrelor, to investigate differential effects on mortality of P2Y12 inhibitors.ResultsData for the analysis cohorts, totalling 37,372 patients, were extracted from publications and cover a widely comparable spectrum of patient types, defined by the type of ACS and treatment strategy. The meta-regression lines for cardiovascular mortality with prasugrel or ticagrelor (each versus clopidogrel), as well as for both agents pooled, indicate a linear relationship with increasing benefit seen with higher underlying risk (p = 0.007, 0.021 and 0.003, and R2 = 0.87, 0.77 and 0.62, respectively).ConclusionsIn the ACS patients studied, we found a mortality benefit with the two newer oral P2Y12 inhibitors prasugrel and ticagrelor when compared with clopidogrel, which increases progressively as the underlying risk of death increases. This appears to be a class effect for these two newer agents.
       
  • Patent hemostasis and comparison of two compression devices after
           transradial coronary catheterization and intervention
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Štěpán Jirouš, Ivo Bernat, Jan Duršpek, Richard RokytaAbstractAimThe aim of this study was to compare two compression devices after transradial coronary catheterization and intervention.MethodsOut of 280 consecutive patients who underwent cardiac catheterization and intervention (n = 74) as a part of a same-day discharge program, 140 patients were applied the TR Band (TB) compression device and 140 the Seal-One (SO) compression device. The time needed to achieve patent hemostasis, duration of compression and local complications were assessed.ResultsIn the TB group, patent hemostasis was achieved in 17.5 ± 10.3 min (min), in the SO group in 21.4 ± 10.5 min (p = NS). The duration of radial artery compression was 90.7 ± 38.4 min in the TB group and 64.0 ± 26.5 min in the SO group (p 
       
  • Late outcomes after interventional treatment – Successful stenting of
           Takayasu arteritis lesions. Single center experience in Bulgaria
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Ivo S. Petrov, Iveta G. Tasheva, Svetlin N. Tsonev, Zoran Stankov, Silvia A. Pavlova, Lachezar N. GrozdisnkiAbstractAimThe studied group included patients at different age and gender with follow-up period at least 1 year. The work represents endovascular treatment of patients with different localization of the disease and according to the target lesion proper endovascular access was selected.Methods and resultsThe patients are divided into groups, depending on the Numano classification. Seven of studied patients were in age between 33 and 44 years, only 1 was 65 years old, 7 of them were females and 1 male. The patients were accumulated for the period of 1 year.Doppler sonography was used for screening of the patients with known Takayasu disease. Treated lesions were as follows: left subclavian artery – 3 patients, right subclavian artery – 1 patient, right common carotid artery – 1 patient, brachiocephalic trunk – 1 patient, superior mesenteric artery – 2 patients, both external iliac arteries – 1 patient, LAD – 1 patient. Endovascular access of choice were right femoral, right radial, left radial, and right brachial. The used devices were balloon-expandable stents, self-expandable stents, DES/coronary/, PTA only – DCB.ConclusionsAll Takayasu patients in our report were successfully treated with implantation of different types of stents. One year results showed no significant restenosis, except in 1 patient with early restenosis until 6th month.
       
  • Role of echocardiography and cardiac biomarkers in prediction of
           in-hospital mortality and long-term risk of brain infarction in pulmonary
           embolism patients
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): David Vindiš, Martin Hutyra, Daniel Šaňák, Michal Král, Eva Čecháková, Jana Zapletalová, Simona Littnerová, Tomáš Adam, Jan Přeček, Miloš TáborskýAbstractIntroductionThe aim of prospective study was to evaluate the ability of echocardiography and cardiac biomarkers to predict in-hospital mortality and the risk of brain infarction during a 12-month follow-up period (FUP) with anticoagulation in pulmonary embolism (PE) patients.MethodsEighty-eight consecutive acute PE patients (39 men, mean age 63 years) were enrolled; 78 underwent baseline echocardiography and brain magnetic resonance imaging (MRI). After a 12-month FUP, 58 underwent brain MRI. In-hospital mortality and the rates of new ischemic brain lesions (IBL) on MRI with clinical ischemic stroke (IS) events were predicted based on echocardiography (patent foramen ovale presence with right-to-left shunt – PFO/RLS; right/left ventricle diameter ratio – RV/LD; tricuspid annulus plane systolic excursion – TAPSE; tricuspid annulus systolic velocity – ST; pulmonary artery systolic pressure – PASP) and biomarkers results (amino-terminal fragment of brain natriuretic peptide – NT-proBNP and cardiac troponin T – cTnT).ResultsOur series involved 88 patients, of whom 11 (12.5%) presented high-risk PE, 24 (27.3%) intermediate-high risk PE, 19 (21.6%) intermediate-low risk PE and 34 (38.6%) patients had low risk PE.Nine patients (10.2%) died during hospitalization including high-risk PE [6/9 (66.6%)] and intermediate-high-risk PE [3/24 (12.5%)]. cTnT [odds ratio (OR) 4.3; 95% confidence interval 0.59–31.3, P = 0.014], NT-proBNP (OR 14.2 [1.5–133.4], P = 0.02), RV/LD ≥0.79 (OR 36.6 [4.2–316.4], P = 0.001), TAPSE (OR 0.55 [0.34–0.92, P = 0.022) and PASP ≥51.5 mmHg (OR 33.3 [3.8–292.6], P = 0.022) were predictors of in-hospital mortality.Seventeen patients (19.3%) experienced IS (n = 8) or new IBL (n = 9). On multivariate analysis, PFO/RLS (OR 27.1 [3.0–245.3], P = 0.003) and ST ≤14.5 cm/s (OR 34.1 [CI 3.4–344.0], P = 0.003) were independent predictors of IS and IBL risk.ConclusionsHigh blood troponin T, NT-proBNP, RV dilatation/systolic dysfunction and pulmonary hypertension predicted in-hospital mortality. PFO/RLS presence and ST were predictors of clinically apparent/silent brain infarction.
       
  • Successful treatment of peripartum cardiomyopathy with mechanical assist
           devices and cardiac transplantation
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Ingrid Olejarova, Miriam Pavlikova, Michal Hulman, Panagiotis Artemiou, Martin Bena, Ivo Gasparovic, Vladan HudecAbstractIn the severe form of peripartum cardiomyopathy short and long-term continuous flow ventricular assist devices offer a safe bridge to transplant where cardiac transplantation seems to be the only hope and treatment end point for most of these patients. In this report we described the outcome of a 33 years old patient on the 32nd gestational week with peripartum cardiomyopathy who was successfully treated with biventricular mechanical assist devices and cardiac transplantation.
       
  • 2017 ESC Guidelines on the diagnosis and treatment of peripheral arterial
           diseases, in collaboration with the European Society for Vascular Surgery
           (ESVS): Summary of the document prepared by the Czech Society of
           Cardiology and the Czech Society of Angiology
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Debora Karetová, Jana Hirmerová, Jiří Matuška
       
  • Enteric-coated aspirin in cardiac patients: Is it less effective than
           plain aspirin'
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Radovan Jirmář, Petr WidimskýAbstractThe aim of this review article is to make readers aware of the risk of an inadequate antiplatelet effect of enteric-coated formulations of aspirin. Judging by data from studies published to date and exploring the efficacy of various aspirin formulations, there exist sufficient evidences only of a plain form of aspirin absorbed in the stomach. The implication is that patients with coronary heart disease (CHD) should be treated exclusively with the standard formulation of aspirin.
       
  • Carotid endarterectomy during the acute period of ischemic stroke
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): P. Berek, I. Kopolovets, V. Sihotský, M. Kubíková, P. Štefanič, Š. Tóth, Cs. Dzsinich, M. FrankovičováAbstractObjective/backgroundHigh risk of recurrent ischemic stroke within the first 14 days after index event in patients with atherosclerotic stenosis of the carotid arteries gave the impetus for the revision of the term of performing carotid endarterectomy (CEA) in symptomatic patients. Nowadays the advisability of performing urgent CEA within 72 h after stroke onset in neurologically unstable patients is discussed frequently. The paper presents the evaluation of carotid endarterectomy during the acute period of ischemic stroke.MethodsThe results of CEA in 462 patients with symptomatic ICA stenosis performed in two independent Vascular Centers were analyzed. Indication for CEA was stenosis of ICA 50%. In Group I 28.5% of patients underwent CEA within 14 days after stroke onset, and in 71.5% of patients was performed 6 weeks after stroke onset. In Group II 39.5% of patients with unstable neurological symptoms underwent within 3–6 h after stroke onset, and in 60.5% of patients with unstable atherosclerotic plaque, CEA was performed within 24–48 h after stroke onset.ResultsIn Group I (239 people) 7 (2.9%) patients developed stroke. Three (1.3%) patients died. In Group II (223 people) 5 (2.2%) patients developed stroke. One (0.4%) patient died. When comparing complications in the early postoperative period no statistical significance was found.ConclusionsUrgent CEA is indicated in patients with unstable neurological symptoms as well as for those with unstable atherosclerotic plaques. Considering a high risk of stroke recurrence within the first 14 days urgent CEA is effective in the prevention of recurrent stroke. Only 2.2% patients developed postoperatively stroke.
       
  • Management of cardiac sarcoidosis – A practical guide
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Petr Kopriva, Martin Griva, Zbynek TüdösAbstractSarcoidosis is a multi-system granulomatous disorder of unclear etiology which can affect any organ of the body including the heart. The heart is involved in up to 25% of sarcoidosis patients. In rare cases, the heart can be the only organ involved.Involvement of the heart, called cardiac sarcoidosis, especially if symptomatic, significantly deteriorates the prognosis for sarcoidosis patients, which is why cardiac sarcoidosis should be not only considered, but also searched for actively. Despite recent advances in this field, diagnosis, risk-stratification, and treatment of cardiac sarcoidosis remains a challenging issue. Fortunately, several recommendations have been recently formulated which provide relatively clear guidance on the management of patients with cardiac sarcoidosis. The cornerstone of management of these patients is a multidisciplinary approach involving collaboration of cardiologists, pulmonologists, radiologists, rheumatologists, and other specialists.Currently, diagnosis of cardiac sarcoidosis is based on an assessment of a patients’ symptoms, physical examination and results of standard ECG, Holter monitoring and echocardiography. This series of examinations can identify individuals with possible cardiac sarcoidosis, who should undergo, as the next step, cardiac magnetic resonance and positron emission tomography, which are the techniques of choice for the diagnosis of cardiac sarcoidosis. Histological verification, critical for establishing a definitive diagnosis, is based – in cases with a typical picture documented by imaging techniques – on an extracardiac biopsy. In some cases, when an extracardiac biopsy is not feasible, an endomyocardial biopsy is needed.The cornerstone of treatment remains corticosteroids, in some cases in combination with other immunosuppressives, although data on their efficacy and safety from randomized trials are lacking. As the most frequent causes of death from cardiac sarcoidosis are heart rhythm disorders, be it atrioventricular blocks or ventricular arrhythmias, an irreplaceable role in the management of these patients is played by implantation of pacemakers and implantable cardioverter/defibrillators (ICD). One of the most critical issues is risk stratification of patients who, while not meeting classic criteria for ICD implantation, continue to be at high risk of sudden cardiac death and therefore should still be considered for ICD implantation. The last option for patients with advanced sarcoidosis is heart transplantation.The present paper is an overview of presentation, diagnosis, and treatment of cardiac sarcoidosis, with special emphasis on the use of algorithms applicable in routine clinical practice.
       
  • Late infective endocarditis of an Amplatzer atrial septal device twelve
           years after implantation
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Tomáš Toporcer, Adrián Kolesár, Martin Ledecký, František SabolAbstractInfective endocarditis was initially defined as a disease of patients with pre-existing valvular abnormalities. In contemporary medicine a valvular prosthesis and implanted medical devices are the most common risk factors for infective endocarditis.A case report is presented regarding an 18-year-old female with a medical history of a 12-year implanted Amplatzer occluder. Echocardiography showed an endocarditis focus in the right atrium communicating to the left atrium and destruction of the non-coronary leaflet of the aortic valve, with aortic valve insufficiency. Blood culture was positive for multi-resistant Staphylococcus aureus. The aortic valve, the Amplatzer device and part of the anterior leaflet of the mitral valve were excised. Pericardium was used for reconstruction of the anterior leaflet of the mitral valve, the interatrial septum and the wall of the left atrium. A mechanical prosthesis of the aortic valve was implanted. Control echocardiography was done four months after surgery. The evaluation did not show any recurrence of endocarditis.The published literature shows, in correlation with the presented case report, the occurrence of endocarditis late in the course of Amplatzer implantation highlights the need for vigilance in the population of patients with the device.
       
  • Cardiorenal interactions
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Vladimir Tesar, Jan VachekAbstractCardiorenal interactions are bidirectional. Renal hypoperfusion in patients with acute or chronic heart disease is associated with increased mortality and increased risk of end-stage renal disease. Heart damage and/or dysfunction in patients with acute and chronic kidney disease has significant negative impact on the patient survival. Awareness and early diagnosis and therapy may help to ameliorate negative consequences of the other organ damage, especially in acute setting. Search for therapeutic interventions aimed at concomitant cardio- and renoprotection is warranted.
       
  • Inappropriate left ventricular hypertrophy as a tool for risk
           stratification in patients with essential hypertension
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Sergiy LozinskyAbstractThe alternative method of appropriate left ventricular mass prediction in subjects with normal BP and arterial hypertension was proposed. Also the associations of new indicator of LVM inappropriateness with myocardial infarction, stroke and persistent atrial fibrillation were studied.The study consisted of 2 stages. On the first stage 630 untreated hypertensive patients and 206 normotensive persons were studied using methods of office blood pressure (OBP) measurement, echocardiography (ECG), ambulatory blood pressure monitoring (ABPM) and noninvasive central pulse wave analysis (CPWA). Moderate significant correlation (r = 0.58; p = 0.002) between the left ventricular mass index (LVMI) and the product of systolic blood pressure (SBP) and end diastolic dimension (EDD) was found. This correlation was substantially stronger than correlations of LVMI with each of the above mentioned predictors apart and, besides, it was non-inferior compared with existing method for calculation of inappropriate LVM. We established that proposed formula could be improved by using ABPM or noninvasive CPWA parameters. On the second stage of the study 132 patients with essential hypertension, who repeatedly referred to the hospital, were divided depending on LVMI appropriateness. In all of them such events as myocardial infarction (MI), stroke or permanent AF during the period of ≈5 years were recorded. According to our data, inappropriate LVMI was associated with a higher risk of MI especially in patients without LV hypertrophy.
       
  • Biomarkers of renal function in prognostic stratification of patients with
           acute coronary syndrome
    • Abstract: Publication date: April 2018Source: Cor et Vasa, Volume 60, Issue 2Author(s): Jan Přeček, Martin Hutyra, František Kováčik, Jiří Orság, Miloš TáborskýAbstractThere is close pathophysiological interaction between the kidneys and the heart, affecting, among others, the risk for development and prognosis of many cardiovascular disease. Early risk stratification of patients with acute coronary syndrome (ACS) is important for optimizing their therapy. Presented is an overview of prognostic stratification of ACS patients according to baseline levels of renal function biomarkers. Apart from classic biomarkers (creatinine, urea) having a dominant role in advanced chronic kidney disease, some novel biomarkers are listed (cystatin C, neutrophil gelatinase-associated lipocalin, interleukin-18) that bring an added value as they are directly associated with the pathological mechanisms of the course of ACS.
       
  • The long-term effects of individual cardiac rehabilitation in patients
           with coronary artery disease
    • Abstract: Publication date: Available online 31 March 2018Source: Cor et VasaAuthor(s): Vladimír Kincl, Roman Panovský, Jan Máchal, Jiří Jančík, Pavel Kukla, Petr DobšákAbstractBackgroundThe positive effects of cardiac rehabilitation have been repeatedly described and are well-known over the short- and middle-term periods. However there is less knowledge about long-term outcomes in patients with chronic stable coronary artery disease.AimThe aim of this study was to evaluate the long-term outcome of individual cardiac rehabilitation in patients with coronary artery disease.MethodsOne hundred fifty-two patients with stable coronary artery disease were retrospectively divided into two groups according to their adherence to individual physical activity recommendations, regardless of their participation in guided cardiac rehabilitation training. The IT+ group which participated in individual exercise programmes according to recommendations, were compared with patients who declined these activities (the IT− group). The median follow-up period was 12.7 years.ResultsThe individual training had no long-term effect on survival after being checked for other possible contributing factors, but the multivariate analysis showed a significant association with the occurrence of cardiac events like myocardial infarction, unstable angina, coronary revascularisation and hospitalisation for heart failure: HR (95% CI) 0.51 (0.30–0.89); p = 0.017.ConclusionHome based cardiac rehabilitation and regular physical activity significantly improves long-term cardiac morbidity in patients with coronary artery disease.
       
  • Hyperacute T waves in inferior leads as a dynamic sign of evolving STEMI
    • Abstract: Publication date: Available online 27 March 2018Source: Cor et VasaAuthor(s): Antonio Lippolis, Davide Esposti, Francesco GentileAbstractIntroductionElectrocardiogram is a commonly used tool in the diagnosis of acute myocardial infarction. Among ECG signs of acute cardiac ischemia, tall and broad-based T waves, called hyperacute T waves, may be the earliest and the only ECG sign of ST-elevation myocardial infarction (STEMI).ObjectiveTo underline the importance of early recognition hyperacute T waves as one STEMI equivalent in order to prevent further damage to the myocardium by appropriate treatment.Case reportA 65-year-old female was admitted to the emergency department for chest pain. An electrocardiogram revealed the presence of tall and broad-based T waves in inferior leads, T-waves inversion in D1-aVL and ST-segment depression in V4–V5–V6. Aspirin, ticagrelor, and sublingual nitroglycerin almost fully resolved the patient's chest pain which coincided with the resolution of the tall T waves and improvement of ST-segment depression in V4–V5–V6. Approximately 15 min later, the patient experienced recrudescence of chest pain followed by severe hypotension and sinus bradycardia. Emergent coronary angiography disclosed a complete thrombotic occlusion in the mid-right coronary artery (RCA). Balloon angioplasty and placement of a drug-eluting stent in RCA was performed.ConclusionHyperacute tall and broad-based symmetric T waves are transient and thus uncommonly seen, but they can be the very first ECG evidence of total coronary occlusion and transmural ischemia. Early recognition of this ECG pattern is crucial to ensure diagnosis and optimal treatment of patients with STEMI, which consist in immediate reperfusion by primary angioplasty.
       
  • Cardiac resynchronization therapy in the Czech Republic – Data from the
           EHRA CRT Survey II multicenter registry
    • Abstract: Publication date: Available online 24 March 2018Source: Cor et VasaAuthor(s): Alan Bulava, Přemysl Hájek, Josef Kautzner, Petr Pařízek, Petr Neužil, Rostislav Polášek, Jan Večeřa, Pavel Osmančík, Jan Chovančík, Milena Kubíčková, David Šipula, Kenneth Dickstein, Cecilia Linde, Camilla NormandAbstractIntroductionCardiac resynchronization therapy (CRT) has been proven to lower mortality and morbidity in selected patients with chronic congestive heart failure. The first prospective ESC (European Society of Cardiology) registry showed that indications for CRT were broadly extrapolated to groups of patients, who were not adequately represented in published randomized trials. Significant differences were also documented regarding implantation techniques between different regions and countries. The goal of this article is to explore the second international registry EHRA CRT II Survey and compare the data retrieved from this registry to common clinical practice in the Czech Republic.Methods and resultsTwo ESC associations, the EHRA (European Heart Rhythm Association) and the HFA (Heart Failure Association) designed a second prospective survey to describe current clinical practice regarding CRT. The registry included data on 11,088 patients from 42 ESC member states (ESCMS). In the Czech Republic, 14 centers agreed to participate and finally, 10 actively enrolling centers contributed data from 931 patients (mean age 69.4 ± 9.9 years, 23% women). Mean procedural and X-ray times were significantly lower in the Czech Republic compared to the overall data. Biventricular cardioverter-defibrillators compared to biventricular pacemakers were implanted more often in the Czech Republic (OR 1.74, 95% CI 1.47–2.05, p 
       
  • Residual syntax score can predict short- and long-term outcomes in
           patients with STEMI
    • Abstract: Publication date: Available online 23 March 2018Source: Cor et VasaAuthor(s): Altuğ Ösken, Ramazan Akdemir, Barış Güngör, Ercan Aydın, Salih Şahinkuş, İbrahim Kocayiğit, Yusuf Can, Selçuk Yaylacı, Hüseyin GündüzAbstractObjectivesThe prognostic value of residual Syntax score (rSS) has been observed in different patient groups. However, its prognostic value has not been compared in patients with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).MethodsA total of 208 patients meeting the eligibility criteria were included in the study. Complete revascularisation (CR) was defined as rSS = 0 and incomplete revascularisation (IR) was defined as rSS ≥ 1.ResultsAmong the sample, 78 patients (33.3%) were included in the CR group and 130 patients (67.7%) in the IR group. One patient (1.3%) in the CR group and 8 patients (6.2%) in the IR group died by day 30 (P  0.05). The incidence of recurrent MI (18.5% vs. 7.7%; P 
       
  • Open repair of a symptomatic popliteal artery aneurysm in a 71-year-old
           patient: Case report
    • Abstract: Publication date: Available online 19 March 2018Source: Cor et VasaAuthor(s): Robert Novotny, Stepan Maly, Kvetoslav Lipar, Jaroslav Chlupac, Libor Janousek, Jiri FronekAbstractIntroductionThe most frequent site for true peripheral artery aneurysm formation is the popliteal artery (PA). The clinical presentation of popliteal artery aneurysm (PAA) ranges from the finding of an asymptomatic pulsatile popliteal mass on routine physical examination to acute limb-threatening ischaemia.Case presentationWe are presenting a case of a 71-year-old male patient with 100 m claudication interval on the left lower extremity, with a palpable pulsating circular resistance in the left popliteal fossa. Based on CT angiography results, the patient was diagnosed with a proximal popliteal artery aneurysm (PAA). A posterior approach was used for the dissection of the aneurysm. The aneurysm was carefully dissected between semimembranosus and biceps femoris muscles. Vascular cross-clamps were placed above the proximal PAA on the distal superficial femoral artery (DSFA) and below on the popliteal artery (PA) between PA1 and PA2 segments. The aneurysm was removed, and surgical revascularisation with end-to-end anastomosis to the DSFA and proximal PA was performed with a 7 mm polyethylene-terephthalate vascular prosthesis. The patient was discharged on the third postoperative day without any complications with patent vascular graft and palpable crural arteries. The patient remains with a patent prosthetic graft 4 month after the surgery without any ultrasonographic signs of stenosis.ConclusionUp-to-date, open surgical resection remains a gold standard in the treatment of PAA with superior long-term results over endovascular techniques. Nevertheless, new endovascular techniques are becoming more sophisticated, allowing us to use these endovascular modalities as an alternative treatment option in selected patients.
       
  • Infarction of the left atrium resulting in its rupture
    • Abstract: Publication date: Available online 17 March 2018Source: Cor et VasaAuthor(s): O. Kucerka, P. Sedlon, E. Traboulsi, M. MalyAbstractAlthough atrial myocardial infarction is an entity that has been reported for decades, it is frequently neglected in clinical practice. Isolated infarction of an atrium is rare, usually occurring concomitantly with ventricular myocardial infarction. The major complications of atrial infarction are cardiac arrhythmias, thromboembolization and atrial rupture. We report an 84-year-old male patient with left atrial rupture following subacute inferolateral STEMI and left atrial infarction.
       
  • Cardiology Rehabilitation wards: Isolation of Staphylococcus capitis. A
           risk of infection to be kept under control
    • Abstract: Publication date: Available online 13 March 2018Source: Cor et VasaAuthor(s): Pasqualina Laganà, Santi Delia, Maria Anna ConiglioAbstractCardiology Rehabilitation wards specialize in the rehabilitation of patients who are suffering from cardiac surgery or an acute heart attack. Hospital Infections are the most frequent and severe complication of healthcare. Nevertheless, during the last two decades, coagulase-negative staphylococci (CoNS) have indicated as the primary cause of infections and septicemia in cardiology care units. Among the CoNS, the role played by Staphylococcus capitis in the field of infectious processes has been considered. We present our experience of S. capitis isolations from a patient admitted with cardiovascular disease with lower limbal diabetic ulcers.
       
  • Acute coronary syndrome and coronary microfistulae left ventricular. A
           rare event, but possible
    • Abstract: Publication date: Available online 12 March 2018Source: Cor et VasaAuthor(s): Francesco Messina, Sergio CroscaAbstractCoronary fistulae are rare anatomic anomalies and those ones draining in left ventricle have low incidence. Apical hypertrophy of left ventricle is a relatively rare manifestation of hypertrophic cardiomyopathy, sometimes associated with coronary fistulae. We show the case of a coronary microfistulae draining on left ventricle associated with an apical hypertrophic cardiomyopathy which manifested for the first time as an acute coronary syndrome NSTEMI.
       
  • Rare cause of recurrent systemic embolism in a middle-aged woman with
           undiagnosed lung A-V malformation
    • Abstract: Publication date: Available online 1 March 2018Source: Cor et VasaAuthor(s): Blažej Rácz, Aleš Linhart, Jan Bělohlávek, Vladimír Mikulenka, Robert Šachl, Petr VařejkaAbstractWe report a case of the recurrent systemic embolism in a 48-year-old woman without previous medical history. Gradual clinical development revealed a combination of rare anatomical and pathological findings. The first manifestation of the disease in the patient was repeated systemic embolization in the left arm requiring repeated surgical embolectomy in a very short time sequence. In a parallel search for a possible source, clinically silent pulmonary embolism, patent foramen ovale and significant vascular A-V malformation in the left lung were diagnosed. In the subsequent period, there was an unexpected event of an acute massive myocardial infarction, again of embolization origin. The source of embolization in the left coronary artery was surprisingly discovered in the ascending aorta. The following text details the course of this patient's illness.The case also points out that despite the maximum and well-timed diagnostic and extensive therapeutic options of modern cardiology and interdisciplinary cooperation, there are still rare and surprising cases of patients with hypercoagulable conditions where the cause of morbidity cannot be fully explained. Despite the maximum effort and therapy, it is difficult to avert any further complications of such condition.
       
  • Scimitar syndrome – A case report
    • Abstract: Publication date: Available online 15 February 2018Source: Cor et VasaAuthor(s): Juraj Bujdák, Jiří Vondrák, Jan Matějka, Pavel Král, Bořivoj KorbelAbstractThe authors present a case of a rare congenital cardiopulmonary anomaly. In the discussion section, possible associated disorders, clinical syndromes and diagnostic possibilities are considered. The case report is supported by the chest radiograph and the 2D and 3D computer tomography scans.
       
  • Development of early reperfusion after the first episode of acute
           pulmonary embolism
    • Abstract: Publication date: Available online 6 February 2018Source: Cor et VasaAuthor(s): Jana Václavková, Jan Mrózek, Vladimír Janovský, Pavol Bindas, Jana Petrová, Luboš Kraus, Michal Svoboda, Pavel JansaAbstractIntroductionFactors influencing the early reperfusion after pulmonary embolism (PE), with possible impact on development of chronic thromboembolic disease and chronic thromboembolic pulmonary hypertension (CTEPH), have not been completely identified yet.Study population and methodsThe total of 85 patients hospitalized with the first episode of acute PE underwent a ventilation–perfusion lung scan before hospital discharge. The reperfusion was evaluated based on clinical, echocardiographic and laboratory parameters.ResultsThe study population consisted of 37 men and 48 women, mean age 60 years. A high-risk PE was present in 9.4% of patients, medium-risk PE in 49.4% and low-risk PE in 41.2% of patients. 26 (30.5%) of patients were diagnosed with provoked pulmonary embolism. Prior to discharge, the residual perfusion defects were detectable in 66 patients, in 18 patients the perfusion was normal. The two groups did not significantly differ in clinical, echocardiographic or laboratory parameters.ConclusionThe analysis did not identify risk factors significantly associated with the absence of early reperfusion of the PE. This points toward the need of further follow-up of patients after a PE with the aim of identifying the patients with the high risk of developing the chronic thromboembolic disease and CTEPH.
       
  • Infectious aneurysm of the ascending aorta – Successful conservative
           treatment in a high-risk patient
    • Abstract: Publication date: Available online 1 February 2018Source: Cor et VasaAuthor(s): Vaclav Pavliňák, Petr Vařejka, Jean-Claude LubandaAbstractInfectious aortic aneurysm is a rare disease requiring early and comprehensive management to prevent the development of serious complications. While surgical repair is still the gold standard, an endovascular approach is an alternative for some patients. Conservative management is traditionally associated with the worst prognosis. We report a case of an infectious aneurysm of the ascending aorta with an atypical clinical manifestation and a complicated diagnostic process, which resulted in successful comprehensive conservative management of a high-risk patient who rejected radical surgical treatment.
       
  • Late recurrence of fulminant myocarditis related to HSS/DRESS
    • Abstract: Publication date: Available online 1 February 2018Source: Cor et VasaAuthor(s): Miguel Ardérius, Miguel Nobre Menezes, Tiago Marques, Dulce Brito, Ana Ortins-Pina, Mónica Mendes Pedro, Fausto Pinto, Fátima VeigaAbstractHypersensitivity Syndrome or Drug Reaction with Eosinophilia and Systemic Symptoms (HSS/DRESS) is a rare pharmacological hypersensitivity reaction that may include cardiac involvement, with high mortality and long-term heart failure.A 28-year-old woman, two months after the diagnosis of DRESS secondary to sulfasalazine, developed fulminant eosinophilic necrotizing myocarditis. After intensive multiorgan support, recovery and cardiac function normalization were observed. Eight months later presented a recurrence with fast progression to refractory cardiogenic shock and death.We alert to a rare and underdiagnosed pathology, with adverse prognosis, needing timely identification and treatment.
       
  • Alternating bundle-branch block in acute coronary syndrome
    • Abstract: Publication date: Available online 1 February 2018Source: Cor et VasaAuthor(s): Matic Avsec, Misa Fister, Marko Noc, Peter RadselAbstractBackgroundBundle-branch blocks often blur ischemic ECG changes. Alternating bundle-branch block is not yet fully understood but can hold clinical significance.Case reportWe present a case of a patient with a known left bundle-branch block (LBBB) who developed a new right bundle-branch block (RBBB) in a setting of acute coronary syndrome. Coronary angiogram revealed subtotal proximal LAD stenosis that was resolved with stent implantation. After the percutaneous coronary intervention RBBB disappeared and LBBB reappeared. The probable reason for the alternating bundle-branch block in the presented case is a new origin of ventricular impulses after initial medical treatment. New onset RBBB has been an intriguing clinical entity often associated with acute myocardial infarction. RBBB could be added to ST-elevation myocardial infarction as an equivalent indication for urgent reperfusion therapy.Why should an emergency physician be aware of this' Alternating bundle-branch block can be an indicator of reperfusion, thus changing the management of an acute coronary syndrome patient.
       
  • Cardiac implantable electronic devices and chemotherapy: A risky
           combination
    • Abstract: Publication date: Available online 17 January 2018Source: Cor et VasaAuthor(s): Michele Scarano, Germana Gizzi, Domenico Mastrodicasa, Cesare MantiniAbstractThe incidence of infective endocarditis in subjects with cardiac implantable electronic devices (CIEDs) is not an uncommon complication. Diabetes mellitus, chronic kidney disease, oral corticosteroids, malignancies and congestive heart failure represent common risk factors for cardiac device-related endocarditis (CDE); however, chemotherapy (CHT) may also play an important role in this serious complication. We present a case of CHT-induced CDE in a 64-year-old male with multiple cardiac risk factors.
       
  • The positive impact of a four-week Cardiac Rehabilitation program on
           depression levels of cardiological patients
    • Abstract: Publication date: Available online 17 January 2018Source: Cor et VasaAuthor(s): Floriana Caccamo, Simone Saltini, Cristina Marogna, Vito Sava, Roberto Carlon, Federico VignagaAbstractPurposeTo investigate the positive impact of a Cardiac Rehabilitation program on levels of depression in patients after an acute cardiac event and to verify if some socio-demographic variables, as diagnosis, gender and age, and variables related to work and social support (working occupation, marital status, presence/absence of children) could be considered as predictors of depression, both at the beginning and at the end of the Cardiac Rehabilitation.MethodsOne hundred and twenty-two patients completed the BDI-II questionnaire for evaluate depressive symptoms, before and after a four-week Cardiac Rehabilitation program. Changes in the scores were compared using paired t-test. Linear regression was used to verify predictors of depression.ResultsMean BDI-II scores decreased significantly between PRE-and POST evaluation, both in the affective factor (t = 2.66, p 
       
  • Left atrial myxoma complicated with a myocardial infarction in a
           10-year-old boy: A case report and review of the literature
    • Abstract: Publication date: Available online 17 January 2018Source: Cor et VasaAuthor(s): Ahmed. Sghaier, Nejeh. Ben Halima, Ghada. Hamila, Houssem Thabet, Marwa. Ben Abdallah, Yossra. MessaoudiAbstractA 10-year-old child experienced syncope on exertion, preceded by chest pain and palpitations. The physical exam had no particularities except for a diastolic roll at the mitral area. The initial electrocardiogram showed a ventricular tachycardia successfully wiped out by cardioversion. The electrical control showed an extensive anterior myocardial infarction. Emergency Doppler echocardiography showed a dilated LV, akinesia of the apical and middle segments of the anterolateral wall and of the apex with a reduced LVEF of 35%. A mass covering almost all of the left atrium was noted evoking a myxoma. A thoracic angiography scan and a coronary-scan confirmed the diagnosis, showed anterior cardiac ischemia and normal coronary arteries. The final diagnosis was a left atrial myxoma complicated by a coronary artery embolism. The child underwent surgical resection. Histopathological examination confirmed the diagnosis.In this paper, a review of the literature concerning left atrial myxomas complicated with coronary embolisms in children showed the rarity but severity of such association, thus requiring a high degree of clinical awareness to obtain a timely diagnosis and to not delay the treatment.
       
 
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