Cardiology Letters, 2020 (vol. 29), issue 1

Long-term left ventricular assist devices in the treatment of heart failure in Slovakia

Lesný P, Hulman M, Olejárová I, Hudec V, Gašparovič I, Šramatý R, Luknár M, Gonçalvesová E

Cardiology Letters 2020, 29(1):50-56  

Aim: To evaluate survival and to analyse causes of mortality and morbidity in patients after left ventricular assist device (LVAD) implantation. To conceive our current strategy of LVAD use in the treatment of heart failure (HF). Patients and methods: One hundred and twenty-seven patients (88% men) were analysed. Mean age was 49.6 ± 11.7 years. All patients were in NYHA class IV, left ventricular ejection fraction was 18.4 ± 5.4%, and cardiac index 1.8 ± 0.5 L/min/m2. At the time of implant, 74% of patients were inotrope-dependent (Intermacs profile 1-3), 15% of patients were in cardiogenic shock (Intermacs 1). LVAD implant strategy...

Heart failure and diabetes mellitus. Dangerous association

Gonçalvesová E

Cardiology Letters 2020, 29(1):9-16  

Increased risk of cardiovascular disease in type 2 diabetes mellitus (DM II) is generally understood in association with the higher incidence of atherosclerotic vascular occlusive events such as myocardial infarction, stroke and atherosclerotic peripheral artery disease. However, one of the most common and serious cardiovascular disorders in patients with diabetes is heart failure (HF). Patients - men with DM II are at more than three times higher risk of developing HF; in women with diabetes the risk is up to five times higher. After the clinical manifestation of HF in a diabetic patient, prognosis is much worse than without HF. Some surveys show...

Cardiac amyloidosis - rare or underdiagnosed?

Danková M, Gonçalvesová E

Cardiology Letters 2020, 29(1):17-25  

Amyloidosis is a heterogenous disease consisting of the depositing of proteinous substance (amyloid) in body tissues. Cardiac amyloidosis is characterized by clinically significant extracellular amyloid infiltration of the heart by amyloid. Cardiac involvement represents the most important prognostic factor in AL amyloidosis and thus early diagnosis of amyloid heart disease is most important for further management. Recent clinical research has shown that amyloidosis, particularly TTR, is not so rare as it was thought. This review aims to discuss pathogenesis, manifestation, complex diagnostics and current therapeutic options of amyloidosis with the...

Baroreceptor activation therapy - new approach in therapy of patients with advanced chronic heart failure and with reduced left ventricular ejection fraction

Dlesk A, Danková M, Lesný P, Luknár M, Gonçalvesová E

Cardiology Letters 2020, 29(1):26-33  

Undesirable persistent sympathetic nervous system activation is an important mechanism in pathogenesis of chronic heart failure which is involved in the progression of the disease and negatively affects patient survival. This finding led to the hypothesis that restoring the physiological balance of the autonomic nervous system could delay the progression of heart failure and lead to an improved prognosis of patients with this disease. For this purpose, two therapeutic approaches have been developed and experimentally and clinically tested in the past - vagal nerve stimulation and baroreceptor activation. Direct cervical vagal nerve stimulation involves...

Secondary mitral regurgitation and chronic heart failure

Líška B, Pacák J, Postulka J, Fridrich V, Gonçalvesová E

Cardiology Letters 2020, 29(1):34-43  

Secondary mitral regurgitation is a frequent finding in chronic heart failure patients. It is an independent prognostic predictor associated with a 50% 5-year mortality. The change in left ventricular geometry caused by local or global wall motion abnormalities is currently considered to be the key mechanism of secondary mitral regurgitation. It results in tethering of mitral valve apparatus, systolic restriction and subsequent leaflet coaptation failure. The guidelines - oriented chronic heart failure drug therapy is the first line treatment in patients with secondary mitral regurgitation which can achieve a significant reduction in regurgitant volume....

Structural valve deterioration

Vranka I, Fridrich V, Gonçalvesová E

Cardiology Letters 2020, 29(1):44-49  

Transcatheter aortic valve implantation (TAVI) has initiated interest about the degenerative process of bioprosthesis. Bioprostheses are used in preference over mechanical valves in cardiosurgery and are exclusively used in TAVI procedure. Extending the use of TAVI in low risk group patients (more than 80% of all severe aortic stenosis) and TAVI as a treatment option in younger patients with longer life expectancy increases the importance of longterm durability and reliable function of bioprostheses. Although follow-up data are only medium term, transcatheter bioprotheses does not look worse than surgically implanted. Bioprostheses valve degeneration...

Complication of pulmonary hypertension?

Chudý M, Gonçalvesová E

Cardiology Letters 2020, 29(1):57-58  

Aneurysm of left ventricle and LVAD implantation

Chudý M, Hulman M, Gonçalvesová E

Cardiology Letters 2020, 29(1):59-60  

Rare diseases in cardiology: small volume, great importance

Luknár M, Gonçalvesová E

Cardiology Letters 2020, 29(1):61-63