Cardiology Letters - Latest articles
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Acute propafenone toxicityCase report
Michal Kerekanič, Alžbeta Kollárova
Cardiology Letters 2026, 35(3):164-168 
Propafenone is an antiarrhythmic drug commonly used in the treatment of cardiac rhythm disorders. Although it is considered a relatively safe medication, certain circumstances may lead to its toxicity, resulting in various serious cardiac and extracardiac symptoms. In the presented case report, we describe a patient long-term treated with propafenone for atrial fibrillation who was admitted to the arrhythmology department acutely with severe bradycardia, cardiogenic shock, and ECG changes suggestive of propafenone toxicity. Early management, including vasopressor therapy, temporary cardiac pacing, and administration of sodium bicarbonate, prevented...
Prevalence and symptom characteristics of Postural Orthostatic Tachycardia Syndrome (POTS) in patients with orthostatic intoleranceOriginal article
Monika Lukáčová, Peter Mitro, Kristína Valová
Cardiology Letters 2026, 35(3):155-163
Introduction: Postural orthostatic tachycardia syndrome (POTS) is a form of orthostatic intolerance characterized by an excessive increase in heart rate upon standing in the absence of orthostatic hypotension. Aim: To assess the prevalence of POTS among patients evaluated for orthostatic intolerance and to analyze symptom characteristics across different POTS phenotypes. Methods: Between 2021 and 2024, a total of 816 head-up tilt (HUT) tests were performed at our institution for the evaluation of orthostatic intolerance. POTS was diagnosed in 27 patients (3.5%), of whom 17 underwent comprehensive autonomic testing, including the active standing test...
Corrected QT interval assessment: artificial intelligence versus physicianOriginal article
Ján Šuba ml., Martin Dúbrava
Cardiology Letters 2026, 35(3):146-154
Background: Quantification of the corrected QT interval (QTc) is of major importance for risk stratification of torsades de pointes and arrhythmogenic sudden cardiac death, particularly when QTc exceeds 500 ms. Aim: The aim of the study was to compare QTc interval assessment between the widely available multimodal AI assistant ChatGPT version 5.2 "Thinking", the specialized AI application PMcardio, automated ECG device measurement, and physician measurement. Patients and Methods: The analysis included 115 anonymized 12-lead electrocardiograms from hospitalized patients. The mean age was 80.8 years, and 58.3% were women. Using a standardized methodology,...
Infective endocarditis - The 16-year experience of one centreOriginal article
Peter Snopek, Jozef Hasilla, Jakub Benko
Cardiology Letters 2026, 35(3):138-145
Background: Infective endocarditis (IE) is a serious disease, the incidence and mortality of which remain high despite advances in medicine. We decided to investigate its etiology, echocardiographic findings, comorbidities, complications, and their impact on mortality in a group of patients hospitalized for infective endocarditis (IE) at the Cardiology Department of the University Hospital Nitra from 1. 1. 2008 to 31. 12. 2023. Methodology: Retrospective analysis of patients hospitalized for IE at the Cardiology Department of the University Hospital Nitra from January 1, 2008, to December 31, 2023. Results: During the 16-year follow-up, 170 patients...
Komentár k odporúčaniam ESC/EACTS pre manažment chlopňových ochorení z roku 2025 Čo je nové oproti odporúčaniam z roku 2021?Editorial
Martin Hudec, Gabriel Valočik
Cardiology Letters 2026, 35(3):133-137
Acute perimyocarditis as the initial manifestation of adult-onset Still's diseaseCase report
Luís Cotrim, António Carvalho, Mariana Gaspar, Mariana Marques Silva, Pedro Custódio
Cardiology Letters 2026, 35(2):113-117
Adult-onset Still's disease (AOSD) is a rare systemic autoinflammatory disorder characterized by quotidian high-spiking fever, inflammatory arthralgia, and an evanescent salmon-coloured rash. Cardiac involvement is uncommon but may include pericarditis and, less frequently, myocarditis. We report the case of an 18-year-old male presenting with persistent fever, myalgias, and arthralgia. Laboratory investigation demonstrated markedly elevated C-reactive protein (CRP 419 mg/L) and increased high-sensitivity cardiac troponin T (10511 ng/L). Electrocardiography showed sinus tachycardia with T-wave inversion in the inferolateral leads, and transthoracic...
Current approach to cardiogenic shock managementReview
Elena Teringová
Cardiology Letters 2026, 35(2):99-112
Cardiogenic shock is a severe syndrome that continues to be associated with high mortality despite advances in diagnostics and treatment. In recent years, significant progress has been made in establishing relevant definitions, classifications, and refining therapeutic approaches. The introduction of the SCAI staging systwem, the SHARC etiological classification, and hemodynamic phenotyping has enabled more accurate risk stratification and more effective therapeutic decision-making. Early diagnosis based on clinical, laboratory, and imaging parameters is essential for the prompt initiation of treatment. Management consists of a combination of initial...
What a cardiologist should know about the need for thrombophilia screening - the latest recommendationsReview
Juraj Sokol, František Nehaj, Peter Hlivák, Lenka Lisá, Ľudmila Lineková, Richard Jusko, Ivana Plameňová, Pavol Hollý, Ján Staško
Cardiology Letters 2026, 35(2):90-98
Thrombophilia represents a congenital or acquired predisposition to thrombosis; however, its assessment is clinically meaningful only in situations where it can influence therapeutic or preventive management. The overuse of thrombophilia screening in cardiology practice remains a frequent problem despite its limited benefit in many clinical settings. Current evidence and the latest 2025 recommendations of the Slovak Society of Hemostasis and Thrombosis emphasize the need for a selective and rational approach. Screening is mainly indicated in young patients with unprovoked or recurrent venous thromboembolism, thrombosis at atypical sites, or specific...
Right ventricular free wall longitudinal strain in heart failure with preserved and mild reduced ejection fraction. Application and prognostic implicationsOriginal article
Daniel Grados-Saso, Juan Manuel Salvador-Casabón, Anyuli García-Gutiérrez, Ana María Martínez-Royo, Juan Ignacio Pérez-Calvo, Isaac Lacambra-Blasco
Cardiology Letters 2026, 35(2):83-89
Aims: Right ventricle (RV) plays an important role in heart failure with preserved and mild reduced ejection fraction. Quantification of right ventricular functional parameters by echocardiography is challenging. In this context an advanced quantification parameter such as right ventricular strain (a measure of myocardial deformation) represents a tool that can provide useful information in the assessment of RV function, with potential prognostic implications. Methods: In a cohort of 71 prospectively included patients admitted for an episode of heart failure with preserved and mild reduced ejection fraction (LVEF >40%) right ventricular function...
Medziodborové stanovisko k bezpečnosti perorálnej gestagénovej antikoncepcie u žien s prítomnosťou rizikových faktorov venózneho tromboembolizmu, kardiometabolického rizika alebo intoleranciou estrogénovej zložky hormonálnej antikoncepcieOpinion of professional societies
Juraj Payer, Miroslav Borovský, Peter Jackuliak, Peter Turčáni, Mária Hulíková, Alexandra Krištúfková, Vladimír Cupaník, Eva Gonҫalvesová
Cardiology Letters 2026, 35(2):77-82
Komentár k odporúčaniam ESC pre manažment kardiovaskulárnych ochorení v gravidite 2025Editorial
Juraj Dúbrava, Miroslav Korbeľ
Cardiology Letters 2026, 35(2):69-75
Guidelines AF 2024 a špecifiká SlovenskaLetter to the editor
#FOOTER#:42
Cardiology Letters 2026, 35(1):42-43
AI that can save time and reduce errorsShort communication
Tomáš Uher, Elena Teringová
Cardiology Letters 2026, 35(1):38-41
This text summarizes selected trends in digital health and artificial intelligence (AI) in cardiology with a focus on day-to-day clinical applicability. It highlights AI use-cases in electrocardiography and cardiovascular imaging, the potential of wearables and remote monitoring, and practical implementation aspects including validation, safety, accountability, and regulatory considerations. The aim is to provide a brief overview of what was presented at the ESC Digital & AI Summit 2025 in Berlin.
Early risk stratification of the patients with non ST-elevation acute coronary syndromes. Results of the SLOVAKS registry from the year 2020Short communication
Martin Studenčan, Martin Hudec, Milan Luknár, Robert Hatala
Cardiology Letters 2026, 35(1):35-37
A proportion of patients with NSTE-ACS, according to the current Recommendations, should be managed invasively within 24 hours of hospitalization. The aim of the work was to determine what proportion of patients with NSTE-ACS hospitalized in Slovakia in 2020 met the valid criteria for very high and high early cardiovascular risk. In the monitored period, 26.07% of patients met the criteria for very high and 51.9% for high early CV risk and therefore could be managed invasively within 24 hours of hospitalization. Tab 1, Ref. 6, on-line full text (Free, PDF), www.cardiologyletters.sk
Trivalvular infective endocarditis: A rare presentation in an intravenous drug userFigures in cardiology
António Carvalho, Luís Cotrim, Pedro Custódio, Pedro Bico
Cardiology Letters 2026, 35(1):33-34
Long COVID and the pathophysiological mechanisms of cardiovascular damageReview
Angelika Púzserová, Peter Bališ, Silvia Dobrodenková, Enikő Potocká, Miroslava Kvandová
Cardiology Letters 2026, 35(1):23-32
Since 2019, SARS-CoV-2 infection has caused significant global morbidity and mortality. Following apparent recovery from acute COVID-19, many patients develop a chronic condition known as long COVID (LC), also referred to as post-COVID syndrome, which can persist for months to years, affect multiple organ systems, and represent a serious public health challenge. LC presents with highly heterogeneous symptoms and is diagnosed clinically due to the absence of specific biomarkers. The underlying pathophysiology is complex and incompletely understood, involving multiple mechanisms including viral persistence, immune dysregulation, microthrombus formation,...
Semaglutide in treatment of obesity and its cardiovascular benefits: evidence from clinical studies and guidelines of European Society of CardiologyReview
Tibor Harcsa
Cardiology Letters 2026, 35(1):17-22
Obesity is a major risk factor for cardiovascular disease. Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist originally developed for the treatment of type 2 diabetes mellitus, has recently been shown to reduce body weight and cardiovascular risk even in patients without diabetes. This review summarizes the available evidence on its metabolic and cardiovascular effects based on the key clinical trials SELECT, STEP HFpEF, and STEP 5, as well as its current position in the recommendations of the European Society of Cardiology. Semaglutide significantly reduces the risk of major adverse cardiovascular events, improves symptoms and functional...
Intimal cardiac sarcoma diagnosis as an unusual cause of anterior myocardial infarctionFigures in cardiology
António Rocha de Almeida, Rafael Coelho Viana, Kisa Congo, Renato Fernandes
Cardiology Letters 2025, 34(5):291-292
Pivotal clinical trials shaping contemporary cardiology practice. News from the European Society of Cardiology Congress 2025Short communication
Miguel Rodriguez Ramos, Gilberto Cairo Saez
Cardiology Letters 2025, 34(5):288-290
This article presents crucial results from clinical trials presented at the European Society of Cardiology Congress on the management of cardiovascular diseases. Relevant therapeutic updates for the coming years are offered while providing critical insights that inform clinical practice and lay the groundwork for future innovations, promising more effective and accessible solutions to the global burden of these diseases. Ref. 8, on-line full text (Free, PDF), www. cardiologyletters.sk
Atypical presentation of infective endocarditis complicated by dietary-induced warfarin resistanceCase report
Adrianna Perzanowska, Zuzanna Tomaszewska, Agata Antoniak, Klaudia Cierlicka
Cardiology Letters 2025, 34(5):283-287
Infective endocarditis (IE) is a life-threatening disease that often presents with nonspecific symptoms, leading to delayed diagnosis. We present the case of a 39-year-old male without significant comorbidities who presented with lower-limb pain, swelling, and systemic symptoms, initially misdiagnosed as pneumonia. Computed tomography (CT) angiography revealed a thrombus in the distal posterior tibial artery, but IE was suspected only after a new heart murmur was detected. Echocardiography showed vegetations on the aortic valve, mitral valve perforation, and severe aortic regurgitation. Blood cultures remained negative, likely due to prolonged prior...
Endothelial dysfunction as a key pathomechanism of long COVID: a potential therapeutic targetReview
Angelika Púzserová, Peter Bališ, Silvia Dobrodenková, Enikő Potocká, Miroslava Kvandová
Cardiology Letters 2025, 34(5):270-282
Long COVID (LC) refers to the spectrum of long-term health consequences caused by SARS-CoV-2 infection. It includes persistent or new symptoms lasting months to years after the initial infection. Multiple organ systems can be affected, including the cardiovascular system. The pathophysiology of LC is complex and multifactorial, involving viral persistence, immune system dysregulation, endothelial dysfunction, oxidative stress, gut dysbiosis, coagulation disorders, inflammatory processes, and other factors. The endothelium, a key regulator of vascular homeostasis, plays a central role in LC pathophysiology. Endothelial dysfunction leads to altered vascular...
Aldosterone synthase inhibitors in the treatment of arterial hypertensionReview
Juraj Dúbrava
Cardiology Letters 2025, 34(5):261-269
Aldosterone plays a key role in blood pressure regulation. Aldosterone dysregulation occurs in approximately 30% of hypertensive patients. Mineralocorticoid receptor antagonists (MRA) are currently the only class of antihypertensive drugs that specifically target aldosterone. However, MRAs are underused due to concerns about adverse effects; they do not block the nongenomic effect of aldosterone, and are associated with a reactive increase in aldosterone levels. A promising option to MRA are aldosterone synthase inhibitors (ASI), which change the concept of antialdosterone effect. They act "one step ahead" of MRA. ASI inhibit aldosterone synthesis,...
Sinus tachycardia and its differential diagnosisReview
Monika Lukáčová, Peter Mitro, Kristína Valová
Cardiology Letters 2025, 34(4):244-252
Sinus tachycardia is defined as a heart rate exceeding 100 beats per minute. It results from accelerated activation of the sinus node mediated by the autonomic nervous system. It is the most common arrhythmia and serves as a useful physiological response of the body to physical and emotional stress. However, its occurrence in otherwise healthy individuals, in the absence of clearly identifiable triggers, poses a frequent clinical challenge. In certain cases, it may also indicate an underlying pathological condition. This review focuses on the differential diagnosis of sinus tachycardia, with special emphasis on its distinct forms: physiological sinus...
Anticoagulant therapy in a patient with thrombocytopeniaReview
Tomáš Guman, Juraj Sokol, František Nehaj, Juraj Chudej, Lenka Lisá, Ľudmila Lineková, Richard Jusko, Ivan Kecskés, Ivana Plameňová
Cardiology Letters 2025, 34(4):235-243
Anticoagulant therapy in patients with thrombocytopenia represents a clinical challenge that requires careful balancing of bleeding and thrombotic risks. In clinical practice, a minimum platelet count threshold is often taken into account when deciding on anticoagulation; if the count falls below this level, treatment is usually considered too risky. However, this approach is not supported by strong clinical evidence. Thrombocytopenia comprises a heterogeneous group of disorders that can lead to an increased bleeding tendency, yet these conditions do not preclude the development of transient or permanent prothrombotic states that may require prophylactic...
The role of lipoprotein (a) in the pathogenesis of cardiovascular diseasesReview
Miriam Kozárová, Ján Tokarčík, Marcela Valiková-Bavoľárová, Zuzana Kozelová, Ladislav Tomčo
Cardiology Letters 2025, 34(4):227-234
Lipoprotein (a) [Lp(a)] is the lipoprotein under the strongest genetic control. The main determinants of Lp(a) levels are the kringle-IV type 2 (KIV-2) repeat polymorphism (rs10455872 and rs3798220) and two common splice site variants in KIV-2 (4925G>A and 4733G>A) in gene LPA. Lipoprotein(a) plays an independent role in the development of cardiovascular (CV) and cerebrovascular diseases. This is supported by data from Mendelian randomization studies with clear evidence that high levels of Lp(a) increase CV risk even at low LDL cholesterol (LDL-C) levels and by that Lp(a) becomes a very active participant in atherogenesis and aortic stenosis...
Dressler's syndrome - a literature reviewReview
Agata Antoniak, Anna Maria Jocz, Anna Centkowska, Natalia Katarzyna Wagner-Bieleń, Gabriela Helena Dąbrowska, Joanna Karina Banaśkiewicz, Martyna Zwierzchowska, Maria Anna Żmijewska, Jakub Ziółkowski, Aleksandra Maria Żyta
Cardiology Letters 2025, 34(4):221-226
Dressler's syndrome, first described in 1956, is a form of secondary pericarditis classified within the broader category of post-cardiac injury syndromes. It typically occurs several weeks after acute myocardial infarction and is believed to result from an autoimmune response triggered by myocardial necrosis. Once common, its prevalence has declined significantly due to the widespread adoption of reperfusion therapies, including thrombolysis and percutaneous coronary intervention (PCI). This review synthesizes current understanding of Dressler's syndrome, with particular attention to the recommendations of the European Society of Cardiology (ESC)....
Innovative hypolipidemic therapy in the secondary prevention of cardiovascular diseases - the experience of one centreOriginal article
Ján Kmec, Martin Kmec, Daniel Alušík, Miroslav Slanina, Michaela Zigová
Cardiology Letters 2025, 34(4):210-220
Elevated LDL cholesterol (LDL-C) levels are among the major risk factors for atherosclerotic cardiovascular disease. Inclisiran is the first small interfering RNA (siRNA) that reduces plasma LDL-C levels by inhibiting the PCSK9 protein in the liver. Aim: The aim of this study was to evaluate the efficacy and safety of inclisiran administered as monotherapy or in combination with other lipid-lowering therapy in patients with very high cardiovascular risk. Methods: An observational, retrospective, monocentric study enrolled 80 consecutive patients at high cardiovascular risk treated with lipid-lowering drugs, including inclisiran. The efficacy of therapy...
Comment on ESC 2024 Guidelines for the management of peripheral arterial and aortic diseasesEditorial
Mária Rašiová, Juraj Maďarič
Cardiology Letters 2025, 34(4):205-209
Late ICD lead amputation as a cause of recurrent inappropriate shocksFigures in cardiology
Jozef Dodulík, Eva Gonçalvesová
Cardiology Letters 2025, 34(3):187-188
Navigating the unknown: a unique pacemaker implantationFigures in cardiology
Rafael Coelho Viana, Marta Paralta de Figueiredo, Bruno Miguel Cordeiro Piçarra, Pedro Miguel Loureiro Santarém Semedo
Cardiology Letters 2025, 34(3):186