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Medilek K, Bis J, Polansky P, Kvasnicka T, Borg A, Dusek J, Brtko M, Tuna M, Praus R, Ballon M, Stasek J, Littnerova S, Parizek P. Computed tomography is better than echocardiography in predicting balloon-expandable transcutaneous implantation valve size in a real-world clinical practice single-center study. Echocardiography 2023; 40:784-791. [PMID: 37417924 DOI: 10.1111/echo.15643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/06/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023] Open
Abstract
AIMS Transcatheter aortic valve replacement (TAVR) has become the standard of care for selected patients with severe aortic stenosis. Multidetector computed tomography (MDCT) and transoesophageal 2D/3D (two-dimensional/three-dimensional) echocardiography (ECHO) are used for aortic annulus (AA) sizing. The aim of this study was to compare the accuracy of AA sizing by ECHO versus MDCT for Edwards Sapien balloon expandable valve in a single center. METHODS AND RESULTS Data from 145 consecutive patients with TAVR (Sapien XT or Sapien S3) were analyzed retrospectively. A total of 139 (96%) patients had favorable outcomes after TAVR (at most mild aortic regurgitation and only one valve implanted). The 3D ECHO AA area and area-derived diameter were smaller than the corresponding MDCT parameters (464 ± 99 vs. 479 ± 88 mm2 , p < .001, and 24.2 ± 2.7 vs. 25.0 ± 5.5 mm, p = .002, respectively). The 2D ECHO annulus measurement was smaller than both the MDCT and 3D ECHO area-derived diameters (22.6 ± 2.9 vs. 25.0 ± 5.5 mm, p = .013, and 22.6 ± 2.9 vs. 24.2 ± 2.7 mm, p < .001, respectively) but larger than the minor axis diameter of the AA derived from MDCT and 3D ECHO by multiplanar reconstruction (p < .001). The 3D ECHO circumference-derived diameter was also smaller than the MDCT circumference-derived diameter (24.3 ± 2.5 vs. 25.0 ± 2.3, p = .007). The sphericity index by 3D ECHO was smaller than that by MDCT (1.2 ± .1 vs. 1.3 ± .1, p < .001). In up to 1/3 of the patients, 3D ECHO measurements would have predicted different (generally smaller) valve size than was the valve size implanted with favorable result. The concordance of the implanted valve size with the recommended size based on preprocedural MDCT and 3D ECHO AA area was 79.4% versus 61% (p = .001), and for the area-derived diameter, the concordance was 80.1% versus 61.7% (p = .001). 2D ECHO diameter concordance was similar to MDCT (78.7%). CONCLUSIONS 3D ECHO AA measurements are smaller than MDCT measurements. If 3D ECHO-based parameters alone are used to size the Edwards Sapien balloon expandable valve, then the selected valve size would have been smaller than the valve size implanted with favorable result in 1/3 of the patients. MDCT preprocedural TAVR assessment should be the preferred method over 3D ECHO in routine clinical practice to determine Edwards Sapien valve size.
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Affiliation(s)
- Karel Medilek
- Department of Cardioangiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Faculty of Medicine Hradec Kralove, Charles University Prague, Czech Republic
| | - Josef Bis
- Department of Cardioangiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Pavel Polansky
- Department of Cardiothoracic Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Tomas Kvasnicka
- Department of Radiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Alex Borg
- Department of Cardiology, Mater Dei Hospital, Triq Dun Karm, L-Imsida MSD 2090 and University of Malta, Msida MSD, Malta
| | - Jaroslav Dusek
- Department of Cardioangiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Miroslav Brtko
- Department of Cardiothoracic Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Martin Tuna
- Department of Cardiothoracic Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Rudolf Praus
- Department of Cardioangiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Marek Ballon
- Department of Cardioangiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Josef Stasek
- Department of Cardioangiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Parizek
- Department of Cardioangiology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
- Faculty of Medicine Hradec Kralove, Charles University Prague, Czech Republic
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Sedova P, Kent JA, Bryndziar T, Jarkovsky J, Tomek A, Sramek M, Skoda O, Sramkova T, Pokorová K, Littnerova S, Brown RD, Mikulik R. The decline in stroke hospitalization due to COVID-19 is unrelated to COVID-19 intensity. Eur J Neurol 2023; 30:943-950. [PMID: 36511840 PMCID: PMC9877601 DOI: 10.1111/ene.15664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE During the coronavirus disease 2019 (COVID-19) pandemic many countries reported a decline in stroke volumes. The aim of this study was to analyze if the decline was related to the intensity of the COVID-19 pandemic. METHODS The first pandemic year (1 March 2020 to 28 February 2021) overall and during the three COVID-19 waves were compared with the preceding year. Volumes of acute ischaemic stroke (AIS), subarachnoid hemorrhage, intracerebral hemorrhage and recanalization treatments (intravenous thrombolysis [IVT] and mechanical thrombectomy [MT]) were obtained from the National Register of Reimbursed Health Services. Door-to-needle time, onset-to-door time and National Institutes of Health Stroke Scale at admission were obtained from the Registry of Stroke Care Quality. RESULTS During the pandemic year compared to the preceding year there were 26,453 versus 28,771 stroke admissions, representing an 8.8% decline (p < 0.001). The declines (-10%, -11%, -19%) appeared in COVID-19 waves (spring 2020, autumn 2020, winter 2021) except for an increase (2%) during summer 2020. Admissions for AIS declined by 10.2% (p < 0.001), whilst hemorrhagic stroke volumes were minimally decreased. The absolute volumes of IVT and MT decreased by 9.4% (p < 0.001) and 5.7% (p = 0.16), respectively. However, the proportions of ischaemic stroke patients receiving IVT (18% vs. 18%; p = 0.72) and MT (6% vs. 6%; p = 0.28) remained unchanged. CONCLUSIONS There was a decline in stroke admissions, but such decline was not related to COVID-19 incidence. The frequency of use of recanalization procedures (IVT, MT) and times (onset-to-door time, door-to-needle time) in AIS were preserved in the Czech Republic during the first year of the pandemic.
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Affiliation(s)
- Petra Sedova
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
- International Clinical Research CenterSt Anne's University HospitalBrnoCzech Republic
- Department of Internal Medicine and CardiologyUniversity Hospital Brno and Faculty of Medicine, Masaryk UniversityBrnoCzech Republic
- Department of NeurologySt Anne's University Hospital, and Faculty of Medicine, Masaryk UniversityBrnoCzech Republic
| | | | - Tomas Bryndziar
- International Clinical Research CenterSt Anne's University HospitalBrnoCzech Republic
- Department of NeurologySt Anne's University Hospital, and Faculty of Medicine, Masaryk UniversityBrnoCzech Republic
| | - Jiri Jarkovsky
- Institute of Health Information and Statistics of the Czech RepublicPragueCzech Republic
- Faculty of MedicineInstitute of Biostatistics and Analyses, Masaryk UniversityBrnoCzech Republic
| | - Ales Tomek
- Department of NeurologyCharles University in Prague, and Second Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | - Martin Sramek
- Department of NeurologyCharles University in Prague, and Second Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | - Ondrej Skoda
- Neurological Department and Stroke UnitJihlava HospitalJihlavaCzech Republic
- Department of NeurologyUniversity Hospital Kralovske Vinohrady and Charles University in PraguePragueCzech Republic
| | - Tereza Sramkova
- Department of NeurologyCharles University in Prague, and Second Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | - Kateřina Pokorová
- Institute of Health Information and Statistics of the Czech RepublicPragueCzech Republic
- Faculty of MedicineInstitute of Biostatistics and Analyses, Masaryk UniversityBrnoCzech Republic
| | - Simona Littnerova
- Institute of Health Information and Statistics of the Czech RepublicPragueCzech Republic
- Faculty of MedicineInstitute of Biostatistics and Analyses, Masaryk UniversityBrnoCzech Republic
| | | | - Robert Mikulik
- International Clinical Research CenterSt Anne's University HospitalBrnoCzech Republic
- Department of NeurologySt Anne's University Hospital, and Faculty of Medicine, Masaryk UniversityBrnoCzech Republic
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Doubkova M, Kriegova E, Littnerova S, Schneiderova P, Sterclova M, Bartos V, Plackova M, Zurkova M, Bittenglova R, Lostaková V, Siskova L, Lisa P, Suldova H, Doubek M, Psikalova J, Snizek T, Musilova P, Vasakova M. DSP rs2076295 variants influence nintedanib and pirfenidone outcomes in idiopathic pulmonary fibrosis: a pilot study. Ther Adv Respir Dis 2021; 15:17534666211042529. [PMID: 34515605 DOI: 10.1177/17534666211042529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The antifibrotic drugs nintedanib and pirfenidone are used for the treatment of idiopathic pulmonary fibrosis (IPF). We analysed the association of common profibrotic polymorphisms in MUC5B (mucin 5B, rs35705950) and DSP (desmoplakin, rs2076295) on antifibrotic treatment outcomes in IPF. METHODS MUC5B rs35705950 and DSP rs2076295 were assessed in IPF patients (n = 210, 139 men/71 women) from the Czech EMPIRE registry and age- or sex-matched healthy individuals (n = 205, 125 men/80 women). Genetic data were collated with overall survival (OS), acute exacerbation episodes, worsening lung function and antifibrotic treatment. RESULTS We confirmed overexpression of the MUC5B rs35705950*T allele (55.2% versus 20.9%, p < 0.001) and the DSP rs2076295*G allele (80.4% versus 68.3%, p < 0.001) in IPF compared with controls. On antifibrotic drugs, lower mortability was observed in IPF patients with DSP G* allele (p = 0.016) and MUC5B T* allele (p = 0.079). Carriers of the DSP rs2076295*G allele benefitted from nintedanib treatment compared with TT genotype by a longer OS [hazard ratio (HR) = 7.99; 95% confidence interval (CI) = 1.56-40.90; p = 0.013] and a slower decline in lung function (HR = 8.51; 95% CI = 1.68-43.14; p = 0.010). Patients with a TT genotype (rs2076295) benefitted from treatment with pirfenidone by prolonged OS (p = 0.040; HR = 0.35; 95% CI = 0.13-0.95) compared with nintedanib treatment. Both associations were confirmed by cross-validation analysis. After stratifying by MUC5B rs35705950*T allele carriage, no difference in treatment outcome was observed for nintedanib or pirfenidone (p = 0.784). In the multivariate model, smoking, age, forced vital capacity (FVC) and DLCO (diffuse lung capacity) at the IPF diagnosis were associated with survival. CONCLUSION Our real-world study showed that IPF patients with MUC5B T* allele or DSP G* allele profit from antifibrotic treatment by lower mortability. Moreover, carriers of the DSP rs2076295*G allele benefit from treatment with nintedanib, and TT genotype from treatment with pirfenidone. MUC5B rs35705950 did not impact the outcome of treatment with either nintedanib or pirfenidone. Our single-registry pilot study should be confirmed with an independent patient cohort.
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Affiliation(s)
- Martina Doubkova
- Department of Pulmonology and Physiology, Faculty of Medicine, Masaryk University and University Hospital Brno, Jihlavská 20, 625 00 Brno, Czech Republic
| | - Eva Kriegova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacky University in Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Petra Schneiderova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacky University in Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Martina Sterclova
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
| | - Vladimir Bartos
- Department of Pneumology, Faculty of Medicine in Hradec Králové, Charles University, Prague, Czech Republic
| | - Martina Plackova
- Department of Pneumology, Faculty of Medicine, University Hospital in Ostrava, Ostrava, Czech Republic
| | - Monika Zurkova
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University in Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Radka Bittenglova
- Department of Respiratory Diseases, Faculty of Medicine in Pilsen, Charles University and University Hospital Pilsen, Pilsen, Czech Republic
| | - Vladimira Lostaková
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University in Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Lenka Siskova
- Department of Respiratory Diseases, Tomáš Baťa Regional Hospital, Zlín, Czech Republic
| | - Pavlina Lisa
- Department of Pneumology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Hana Suldova
- Pulmonary Department, České Budějovice Hospital, Ceske Budejovice, Czech Republic
| | - Michael Doubek
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Jana Psikalova
- PneumoAllergology Department, Kroměříž Hospital, Kromeriz, Czech Republic
| | - Tomas Snizek
- Department of Respiratory Diseases, Jihlava Hospital, Jihlava, Czech Republic
| | - Pavlina Musilova
- Department of Respiratory Diseases, Jihlava Hospital, Jihlava, Czech Republic
| | - Martina Vasakova
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
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Sedova P, Brown Jr. RD, Bryndziar T, Jarkovsky J, Tomek A, Sramek M, Skoda O, Sramkova T, Littnerova S, Mikulik R. Treat COVID-19, but Not Only COVID-19: Stroke Matters as Well. Cerebrovasc Dis 2021; 51:52-59. [PMID: 34515067 PMCID: PMC8450853 DOI: 10.1159/000517968] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/16/2021] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION During the COVID-19 pandemic, studies reported less number of hospitalizations for acute stroke and reduction in the use of recanalization treatments. This study analyzes nationwide data on stroke admissions and management in the Czech Republic during the first wave of the COVID-19 pandemic. METHODS We compared the early COVID-19 pandemic (March-May 2020) with the pre-pandemic period (January-February 2020 and March-May 2019): (a) the National Register of Reimbursed Health Services provided volume of all admissions for subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and ischemic stroke (IS), and volume of recanalization treatments (intravenous thrombolysis [IVT] and mechanical thrombectomy [MT]); (b) Registry of Stroke Care Quality provided door-to-needle time (DNT), onset-to-door time (ODT), and stroke severity at admission (National Institutes of Health Stroke Scale, NIHSS) for IS. RESULTS During the pandemic (March-May 2020), the peak number of COVID-19 patients treated in Czech hospitals was 39 per million. In March-May 2020 versus March-May 2019, hospital admissions decreased as follows: stroke overall by 14% (p < 0.001), IS by 14% (p < 0.001), SAH by 15% (p = 0.07), and ICH by 7% (p = 0.17). The mean age was 74 years versus 74 years (p = 0.33), and 52% versus 51% were men (p = 0.34). The volumes of IVT and MT decreased by 14% (p = 0.001) and 19% (p = 0.01), respectively. The proportions of all IS patients receiving IVT or MT remained unchanged, with, respectively, 17% versus 17% receiving IVT (p = 0.86) and 5% versus 5% receiving MT (p = 0.48). DNT and ODT were 24 versus 25 min (p = 0.58) and 168 versus 156 min (p = 0.23), respectively. NIHSS at admission did not differ (6 vs. 6; p = 0.54). CONCLUSION Even with a low burden of COVID-19 during the first wave and no change in organization and logistics of stroke services, stroke admissions and volume of recanalization treatments decreased. Public health communication campaigns should encourage people to seek emergency medical care for stroke symptoms during the COVID-19 pandemic.
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Affiliation(s)
- Petra Sedova
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czechia
- Department of Internal Medicine, Hematology and Oncology, University Hospital Brno, Brno, Czechia
- Department of Neurology, St. Anne's University Hospital, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | | | - Tomas Bryndziar
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czechia
- Department of Neurology, St. Anne's University Hospital, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jiri Jarkovsky
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ales Tomek
- Department of Neurology, Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czechia
| | - Martin Sramek
- Department of Neurology, Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czechia
| | - Ondrej Skoda
- Neurological Department and Stroke Unit, Jihlava Hospital, Jihlava, Czechia
- Department of Neurology, University Hospital Kralovske Vinohrady and Charles University in Prague, Prague, Czechia
| | - Tereza Sramkova
- Department of Neurology, Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czechia
| | - Simona Littnerova
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czechia
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Robert Mikulik
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czechia
- Department of Neurology, St. Anne's University Hospital, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
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Parenica J, Kala P, Mebazaa A, Littnerova S, Benesova K, Tomandl J, Goldbergová Pavkova M, Jarkovský J, Spinar J, Tomandlova M, Dastych M, Ince C, Helanova K, Tesak M, Helan M, Lokaj P, Legrand M. Activation of the Nitric Oxide Pathway and Acute Myocardial Infarction Complicated by Acute Kidney Injury. Cardiorenal Med 2020; 10:85-96. [PMID: 31958795 DOI: 10.1159/000503718] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 09/23/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The pathophysiology of acute kidney injury (AKI) in ST-elevation myocardial infarction (STEMI) patients remains poorly explored. The involvement of the nitric oxide (NO) pathway has been demonstrated in experimental ischemic AKI. The aim of this study was to assess the predictive value of circulating biomarkers of the NO pathway for AKI in STEMI patients. METHODS Four hundred and twenty-seven STEMI patients treated with primary percutaneous coronary intervention were included. The primary end point was AKI. Biomarkers of the NO pathway (plasma superoxide dismutase [SOD], uric acid, nitrite/nitrate [NOx], neopterin) as well as cardiac biomarkers (B-type natriuretic peptide [BNP] and troponin) were sampled 12 h after admission. The predictive value of circulating biomarkers was evaluated in addition to the multivariate clinical model. RESULTS AKI developed in 8.9% of patients. The 3-month mortality was significantly higher in patients with AKI (34.2 vs. 4.1%; p < 0.001). SOD, uric acid, NOx, neopterin, BNP and troponin were significantly associated with the development of AKI (area under curve [AUC]-receiver operating curve [ROC] ranging between 0.70 and 0.81). In multivariate analysis cardiogenic shock, neopterin, NOx and troponin were independent predictors of AKI. AUC-ROC of the association of multibiomarkers and clinical model was 0.90 and outperformed the predictive value of the clinical model alone. OR of NOx ≥45 µmol/L was 8.0 (95% CI 3.1-20.6) for AKI. CONCLUSION Biomarkers of the NO pathway are associated with the development of AKI in STEMI patients. These results provide insights into the pathophysiology of AKI and may serve at developing preventing strategies for AKI targeting this pathway.
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Affiliation(s)
- Jiri Parenica
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia.,Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Petr Kala
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia.,Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Alexandre Mebazaa
- Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France.,Department of Anaesthesiology and Critical Care and Burn Unit, APHP, Saint Louis Lariboisière University Hospitals, Paris, France.,U 942 INSERM, Paris, France
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Klara Benesova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Josef Tomandl
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | | | - Jiří Jarkovský
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jindrich Spinar
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia.,Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Marie Tomandlova
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Milan Dastych
- Department of Biochemistry, University Hospital Brno, Brno, Czechia.,Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Can Ince
- Department of Translational Physiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Katerina Helanova
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia.,Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Martin Tesak
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia.,Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Martin Helan
- Faculty of Medicine, Masaryk University, Brno, Czechia.,Department of Anaesthesiology and Intensive Care, St Anne's University Hospital, Brno, Czechia.,Intensive Care Research, International Clinical Research Centre (ICRC), Brno, Czechia
| | - Petr Lokaj
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia, .,Faculty of Medicine, Masaryk University, Brno, Czechia,
| | - Matthieu Legrand
- Université Paris Diderot, PRES Sorbonne Paris Cité, Paris, France.,Department of Anaesthesiology and Critical Care and Burn Unit, APHP, Saint Louis Lariboisière University Hospitals, Paris, France.,U 942 INSERM, Paris, France.,F-CRIN-INI-CRCT Network, Nancy, France
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Pavlusova M, Miklik R, Benesova K, Spacek R, Zeman K, Littnerova S, Felsoci M, Pohludkova L, Dusek L, Spinar J, Parenica J, Jarkovsky J. P6534Increased dose of diuretics correlates with severity of heart failure and renal dysfunction and does not lead to reduction of mortality and rehospitalizations, data from AHEAD registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Pavlusova
- University Hospital Brno, Department of Cardiology and Internal Medicine, Brno, Czech Republic
| | - R Miklik
- University Hospital Brno, Department of Cardiology and Internal Medicine, Brno, Czech Republic
| | - K Benesova
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czech Republic
| | - R Spacek
- Hospital in Frydek-Mistek, internal department, Frydek-Mistek, Czech Republic
| | - K Zeman
- Hospital in Frydek-Mistek, internal department, Frydek-Mistek, Czech Republic
| | - S Littnerova
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czech Republic
| | - M Felsoci
- University Hospital Brno, Department of Cardiology and Internal Medicine, Brno, Czech Republic
| | - L Pohludkova
- Hospital in Frydek-Mistek, internal department, Frydek-Mistek, Czech Republic
| | - L Dusek
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czech Republic
| | - J Spinar
- University Hospital Brno, Department of Cardiology and Internal Medicine, Brno, Czech Republic
| | - J Parenica
- University Hospital Brno, Department of Cardiology and Internal Medicine, Brno, Czech Republic
| | - J Jarkovsky
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czech Republic
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7
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Spacek M, Hutyra M, Vindis D, Precek J, Sanak D, Kral M, Cechakova E, Littnerova S, Adam T, Hudec S, Taborsky M. P4561Relevance of N-terminal fragment of brain natriuretic peptide in prediction of new cerebral infarcts in acute pulmonary embolism. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Spacek
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
| | - M Hutyra
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
| | - D Vindis
- Palacky University, Faculty of Medicine and Dentistry, Department of Cardiac Surgery, Olomouc, Czech Republic
| | - J Precek
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
| | - D Sanak
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czech Republic
| | - M Kral
- Palacky University, Faculty of Medicine and Dentistry, Department of Neurology, Olomouc, Czech Republic
| | - E Cechakova
- Palacky University, Faculty of Medicine and Dentistry, Department of Radiology, Olomouc, Czech Republic
| | - S Littnerova
- Institute of Biostatistics and Analyses of Masaryk University, Brno, Czech Republic
| | - T Adam
- Palacky University, Faculty of Medicine and Dentistry, Department of Clinical Biochemistry, Olomouc, Czech Republic
| | - S Hudec
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
| | - M Taborsky
- Palacky University, Faculty of Medicine and Dentistry, Department of Internal Medicine 1 - Cardiology, University Hospital, Olomouc, Czech Republic
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8
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Gayat E, Arrigo M, Littnerova S, Sato N, Parenica J, Ishihara S, Spinar J, Müller C, Harjola VP, Lassus J, Miró Ò, Maggioni AP, AlHabib KF, Choi DJ, Park JJ, Zhang Y, Zhang J, Januzzi JL, Kajimoto K, Cohen-Solal A, Mebazaa A. Heart failure oral therapies at discharge are associated with better outcome in acute heart failure: a propensity-score matched study. Eur J Heart Fail 2017; 20:345-354. [PMID: 28849606 DOI: 10.1002/ejhf.932] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 05/26/2017] [Accepted: 06/05/2017] [Indexed: 12/28/2022] Open
Abstract
AIMS Heart failure oral therapies (HFOTs), including beta-blockers (BB), renin-angiotensin system inhibitors (RASi) and mineralocorticoid receptor antagonists, administered before hospital discharge after acute heart failure (AHF) might improve outcome. However, concerns have been raised because early administration of HFOTs may worsen patient's condition. We hypothesized that HFOTs at hospital discharge might be associated with better post-discharge survival. METHODS AND RESULTS The study population was composed of 19 980 AHF patients from the GREAT registry. The primary and secondary outcomes were 90-day and 1-year all-cause mortality, respectively. Survival was estimated with univariate and covariate-adjusted Cox proportional hazards regression models for the whole population and after propensity-score matching. HFOTs at discharge were consistently associated with no excess mortality in the unadjusted and adjusted analyses of the whole and matched cohorts. In the matched cohort, BB and RASi at discharge were associated with lower 90-day mortality risks compared to the respective untreated groups [hazard ratio (HR) 0.56, 95% confidence interval (CI) 0.46-0.69; and HR 0.53, 95% CI 0.42-0.66, respectively]. The favourable associations of BB and RASi at discharge with 90-day mortality were present in many subgroups including patients with reduced or preserved left ventricular ejection fraction and persisted up to 1 year after discharge. The combination of RASi and BB was associated with an even lower risk of death than RASi or BB alone. CONCLUSIONS Administration of HFOTs at hospital discharge is associated with better survival of AHF patients.
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Affiliation(s)
- Etienne Gayat
- Department of Anesthesiology and Critical Care, APHP - Saint Louis Lariboisière University Hospitals, University Paris Diderot and INSERM UMR-S 942, Paris, France
| | - Mattia Arrigo
- Department of Anesthesiology and Critical Care, APHP - Saint Louis Lariboisière University Hospitals, University Paris Diderot and INSERM UMR-S 942, Paris, France.,Division of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Naoki Sato
- Division of Cardiology and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kawasaki, Japan
| | - Jiri Parenica
- Department of Cardiology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Shiro Ishihara
- Division of Cardiology and Intensive Care Unit, Nippon Medical School Musashi-Kosugi Hospital, Kawasaki, Japan
| | - Jindrich Spinar
- Department of Cardiology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Christian Müller
- Cardiovascular Research Institute Basel and Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Veli-Pekka Harjola
- Emergency Medicine, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Johan Lassus
- Division of Cardiology, Heart and Lung Center, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Òscar Miró
- Emergency Department, Hospital Clinic and 'Emergencies: Processes and Pathologies' Research Group, IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Dong-Ju Choi
- Division Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Jin Joo Park
- Division Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Yuhui Zhang
- Heart Failure Center Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Zhang
- Heart Failure Center Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - James L Januzzi
- Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Alain Cohen-Solal
- Department of Cardiology, APHP - Lariboisière University Hospital, and INSERM UMR-S 942, Paris, France
| | - Alexandre Mebazaa
- Department of Anesthesiology and Critical Care, APHP - Saint Louis Lariboisière University Hospitals, University Paris Diderot and INSERM UMR-S 942, Paris, France
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9
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Kubena P, Arrigo M, Parenica J, Gayat E, Sadoune M, Ganovska E, Pavlusova M, Littnerova S, Spinar J, Mebazaa A. Plasma Levels of Soluble CD146 Reflect the Severity of Pulmonary Congestion Better Than Brain Natriuretic Peptide in Acute Coronary Syndrome. Ann Lab Med 2017; 36:300-5. [PMID: 27139601 PMCID: PMC4855048 DOI: 10.3343/alm.2016.36.4.300] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 01/12/2016] [Accepted: 03/02/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acute heart failure negatively affects short-term outcomes of patients with acute coronary syndrome (ACS). Therefore, reliable and non-invasive assessment of pulmonary congestion is needed to select patients requiring more intensive monitoring and therapy. Since plasma levels of natriuretic peptides are influenced by myocardial ischemia, they might not reliably reflect congestion in the context of ACS. The novel endothelial biomarker, soluble CD146 (sCD146), presents discriminative power for detecting the cardiac origin of acute dyspnea similar to that of natriuretic peptides and is associated with systemic congestion. We evaluated the performance of sCD146 for the assessment of pulmonary congestion in the early phase of ACS. METHODS One thousand twenty-one consecutive patients with ACS were prospectively enrolled. Plasma levels of sCD146, brain natriuretic peptide (BNP), and high-sensitive troponin T were measured within 24 hr after the onset of chest pain. Pulmonary congestion on chest radiography was determined and classified in three groups according to the degree of congestion. RESULTS Nine hundred twenty-seven patients with ACS were analyzed. Ninety-two (10%) patients showed signs of pulmonary edema on chest radiography. Plasma levels of sCD146 reflected the radiological severity of pulmonary congestion. Higher plasma levels of sCD146 were associated with the worse degree of pulmonary congestion. In contrast to BNP, sCD146 levels were not affected by the level of troponin T. CONCLUSIONS The novel endothelial biomarker, sCD146, correlates with radiological severity of pulmonary congestion in the early phase of ACS and, in contrast to BNP, is not affected by the amount of myocardial cell necrosis.
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Affiliation(s)
- Petr Kubena
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Mattia Arrigo
- INSERM UMR-S 942, Paris, France.,Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.,Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland
| | - Jiri Parenica
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center-Department of Cardiovascular Disease, University Hospital St Anne's, Brno, Czech Republic
| | - Etienne Gayat
- INSERM UMR-S 942, Paris, France.,Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.,Université Paris Diderot, PRES Sorbonne Paris Cité, France
| | | | - Eva Ganovska
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marie Pavlusova
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jindrich Spinar
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic.,Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Center-Department of Cardiovascular Disease, University Hospital St Anne's, Brno, Czech Republic
| | - Alexandre Mebazaa
- INSERM UMR-S 942, Paris, France.,Department of Anesthesiology and Critical Care Medicine, AP-HP, Saint Louis Lariboisière University Hospitals, Paris, France.,Université Paris Diderot, PRES Sorbonne Paris Cité, France.
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10
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Spinar J, Jarkovsky J, Spinarova L, Vitovec J, Linhart A, Widimsky P, Miklik R, Zeman K, Belohlavek J, Malek F, Cihalik C, Spac J, Felsoci M, Ostadal P, Dusek L, Kettner J, Vaclavik J, Littnerova S, Monhart Z, Malek J, Parenica J. Worse prognosis of real-world patients with acute heart failure from the Czech AHEAD registry in comparison to patients from the RELAX-AHF trial. ESC Heart Fail 2016; 4:8-15. [PMID: 28217307 PMCID: PMC5292638 DOI: 10.1002/ehf2.12105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 06/09/2016] [Accepted: 06/21/2016] [Indexed: 01/10/2023] Open
Abstract
Aims The randomized clinical trial RELAX‐AHF demonstrated a positive effect of vasodilator therapy with serelaxin in the treatment of AHF patients. The aim of our study was to compare clinical characteristics and outcomes of patients from the AHEAD registry who met criteria of the RELAX‐AHF trial (relax‐comparable group) with the same characteristics and outcomes of patients from the AHEAD registry who did not meet those criteria (relax‐non‐comparable group), and finally with characteristics and outcomes of patients from the RELAX‐AHF trial. Methods and results A total of 5856 patients from the AHEAD registry (Czech registry of AHF) were divided into two groups according to RELAX‐AHF criteria: relax‐comparable (n = 1361) and relax‐non‐comparable (n = 4495). As compared with the relax‐non‐comparable group, patients in the relax‐comparable group were older, had higher levels of systolic and diastolic blood pressure, lower creatinine clearance, and a higher number of comorbidities. Relax‐comparable patients also had significantly lower short‐term as well as long‐term mortality rates in comparison to relax‐non‐comparable patients, but a significantly higher mortality rate in comparison to the placebo group of patients from the RELAX‐AHF trial. Using AHEAD score, we have identified higher‐risk patients from relax‐comparable group who might potentially benefit from new therapeutic approaches in the future. Conclusions Only about one in five of all evaluated patients met criteria for the potential treatment with the new vasodilator serelaxin. AHF patients from the real clinical practice had a higher mortality when compared with patients from the randomized clinical trial.
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Affiliation(s)
- Jindrich Spinar
- Department of Internal Medicine and CardiologyUniversity Hospital BrnoBrnoCzech Republic; Faculty of MedicineMasaryk UniversityBrnoCzech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine Masaryk University Brno Czech Republic
| | - Lenka Spinarova
- Faculty of MedicineMasaryk UniversityBrnoCzech Republic; 1st Department of Internal Medicine, Cardiology and AngiologySt. Anne's University Hospital BrnoBrnoCzech Republic
| | - Jiri Vitovec
- Faculty of MedicineMasaryk UniversityBrnoCzech Republic; 1st Department of Internal Medicine, Cardiology and AngiologySt. Anne's University Hospital BrnoBrnoCzech Republic
| | - Ales Linhart
- 2nd Department of Internal Medicine, Cardiology and Angiology, First Faculty of Medicine Charles University in Prague, General University Hospital in Prague Prague Czech Republic
| | - Petr Widimsky
- University Hospital Kralovske Vinohrady, Third Faculty of Medicine Charles University in Prague Prague Czech Republic
| | - Roman Miklik
- Department of Internal Medicine and Cardiology University Hospital Brno Brno Czech Republic
| | - Kamil Zeman
- Department of Internal Medicine Hospital Frydek-Mistek Frydek-Mistek Czech Republic
| | - Jan Belohlavek
- 2nd Department of Internal Medicine, Cardiology and Angiology, First Faculty of Medicine Charles University in Prague, General University Hospital in Prague Prague Czech Republic
| | - Filip Malek
- Department of Cardiology Na Homolce Hospital Prague Czech Republic
| | - Cestmir Cihalik
- Department of Internal Medicine University Hospital Olomouc Olomouc Czech Republic
| | - Jiri Spac
- Faculty of MedicineMasaryk UniversityBrnoCzech Republic; 2nd Department of Internal MedicineSt. Anne's University Hospital BrnoBrnoCzech Republic
| | - Marian Felsoci
- Department of Internal Medicine and Cardiology University Hospital Brno Brno Czech Republic
| | - Petr Ostadal
- Department of Cardiology Na Homolce Hospital Prague Czech Republic
| | - Ladislav Dusek
- Institute of Biostatistics and Analyses, Faculty of Medicine Masaryk University Brno Czech Republic
| | - Jiri Kettner
- Department of Cardiology Institute of Clinical and Experimental Medicine Prague Czech Republic
| | - Jan Vaclavik
- Department of Internal Medicine University Hospital Olomouc Olomouc Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Faculty of Medicine Masaryk University Brno Czech Republic
| | - Zdeněk Monhart
- Department of Internal Medicine Hospital Znojmo Znojmo Czech Republic
| | - Josef Malek
- Department of Internal Medicine Hospital Havlickuv Brod Havlickuv Brod Czech Republic
| | - Jiri Parenica
- Department of Internal Medicine and CardiologyUniversity Hospital BrnoBrnoCzech Republic; Faculty of MedicineMasaryk UniversityBrnoCzech Republic
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11
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Ganovska E, Arrigo M, Helanova K, Littnerova S, Sadoune M, Kubena P, Pavlusova M, Jarkovsky J, Gottwaldova J, Kala P, Dastych M, Ishihara S, Van Aelst LNL, Cohen-Solal A, Gayat E, Spinar J, Parenica J, Mebazaa A. Natriuretic peptides in addition to Zwolle score to enhance safe and early discharge after acute myocardial infarction: A prospective observational cohort study. Int J Cardiol 2016; 215:527-31. [PMID: 27155548 DOI: 10.1016/j.ijcard.2016.04.148] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Revised: 04/12/2016] [Accepted: 04/15/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Zwolle score is recommended to identify low-risk patients eligible for early hospital discharge after ST-elevation myocardial infarction (STEMI), but since only one third of STEMI has low Zwolle score, hospital discharge is frequently delayed. B-type natriuretic peptide (BNP) also provides prognostic information after STEMI. The aim of the study was to test the hypothesis that patients with high Zwolle score associated with low BNP share similar outcomes than those with low Zwolle score. METHODS AND RESULTS The study population consisted of 1032 consecutive STEMI patients in whom BNP was measured 24h after chest pain onset. The area under the curve of Zwolle score and plasma BNP for 30-day mortality were 0.82 and 0.87, p=0.39. A BNP threshold of 200pg/ml had sensitivity of 100% and specificity of 34% for predicting 30-day mortality. Patients with high Zwolle score and BNP≤200pg/ml (n=183) had similar mortality and hospital stay to those with low Zwolle score (0% vs. 0.5% and 5 vs. 5days, both p=1.0). By contrast, patients with high Zwolle score and BNP>200pg/ml had the highest mortality (6.7%) and the longest hospital stay (6days), both p<0.01. CONCLUSION STEMI patients with high Zwolle score but low BNP share similar outcomes with those with low Zwolle score and should be eligible for early discharge. Hence, using the rule of "low-Zwolle or low-BNP" might increase the number of STEMI patients that might be eligible for early discharge.
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Affiliation(s)
- Eva Ganovska
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic.
| | - Mattia Arrigo
- INSERM UMR-S 942, Paris, France; Department of Anesthesiology and Critical Care Medicine, APHP, Saint Louis Lariboisière University Hospitals, Paris, France; Department of Cardiology, APHP, Lariboisière University Hospital, Paris, France; Division of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
| | - Katerina Helanova
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic.
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
| | - Malha Sadoune
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic.
| | - Petr Kubena
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic.
| | - Marie Pavlusova
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic.
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic.
| | - Jana Gottwaldova
- Department of Biochemistry, University Hospital Brno, Brno, Czech Republic; Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Petr Kala
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic.
| | - Milan Dastych
- Department of Biochemistry, University Hospital Brno, Brno, Czech Republic; Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Shiro Ishihara
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic.
| | - Lucas N L Van Aelst
- INSERM UMR-S 942, Paris, France; Department of Cardiology, APHP, Lariboisière University Hospital, Paris, France; KU Leuven, Department of Cardiovascular Sciences, Leuven, Belgium.
| | - Alain Cohen-Solal
- INSERM UMR-S 942, Paris, France; Department of Cardiology, APHP, Lariboisière University Hospital, Paris, France; Université Paris Diderot, PRES Sorbonne Paris Cité, France.
| | - Etienne Gayat
- INSERM UMR-S 942, Paris, France; Department of Anesthesiology and Critical Care Medicine, APHP, Saint Louis Lariboisière University Hospitals, Paris, France; Université Paris Diderot, PRES Sorbonne Paris Cité, France.
| | - Jindrich Spinar
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic.
| | - Jiri Parenica
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic.
| | - Alexandre Mebazaa
- INSERM UMR-S 942, Paris, France; Department of Anesthesiology and Critical Care Medicine, APHP, Saint Louis Lariboisière University Hospitals, Paris, France; Université Paris Diderot, PRES Sorbonne Paris Cité, France.
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12
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Stourac P, Kosinova M, Harazim H, Huser M, Janku P, Littnerova S, Jarkovsky J. The analgesic efficacy of remifentanil for labour. Systematic review of the recent literature. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2016; 160:30-8. [DOI: 10.5507/bp.2015.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 09/04/2015] [Indexed: 02/04/2023] Open
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13
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Parenica J, Kala P, Pavkova MG, Tomandl J, Spinar J, Littnerova S, Jarkovsky J, Mebazaa A, Tomandlova M, Dastych M, Gottwaldova J, Gayat E. Natriuretic peptides, nitrite/nitrate and superoxide dismutase have additional value on top of the GRACE score in prediction of one-year mortality and rehospitalisation for heart failure in STEMI patients - Multiple biomarkers prospective cohort study. Int J Cardiol 2016; 211:96-104. [PMID: 26991556 DOI: 10.1016/j.ijcard.2016.02.135] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 02/05/2016] [Accepted: 02/28/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Blood-based biomarkers have a prognostic value in patients with myocardial infarction. The aim of our prospective observational cohort study was to evaluate the prognostic value of biomarkers of different pathophysiological pathways for the occurrence of 1-year all-cause mortality and hospitalisation due to acute heart failure. METHODS AND RESULTS In 593 patients with ST-segment elevation MI (STEMI) treated by primary PCI, biomarkers were evaluated at 24h after MI onset. A minimum of three-year follow-up was achieved in all patients. The combination of 1-year all-cause mortality and hospitalisation due to heart failure was the primary endpoint. A cohort for validation of our combined GRACE-natriuretic peptide (NP) score included 667 STEMI patients. The primary endpoint was reached in 9.3% of patients. Among 21 biomarkers, only B-type natriuretic peptide (BNP), NT-proBNP, superoxide dismutase and nitrite/nitrate, added to clinical GRACE score led to a significant increase in the area under the curve of C statistics, in comparison to GRACE alone (tested by Delong's test). Continuous net reclassification improvement and integrated discrimination index demonstrated an improved reclassification and discrimination of the GRACE model for SOD, BNP and NT-proBNP, and improved reclassification for nitrite/nitrate. Consistent results for this new combined prognostic model GRACE-NP were found also for a validation cohort. CONCLUSIONS The levels of NP have an additional value to the prognostic properties of the GRACE score for the prediction of the combined endpoint of one-year mortality or hospitalisation for AHF. Nitrite/nitrate and SOD are strong prognostic factors, even on top of the GRACE score.
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Affiliation(s)
- Jiri Parenica
- Cardiology Department, University Hospital Brno, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Kala
- Cardiology Department, University Hospital Brno, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | | | - Josef Tomandl
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Jindrich Spinar
- Cardiology Department, University Hospital Brno, Brno, Czech Republic; Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Alexandre Mebazaa
- Department of Anaesthesiology and Critical Care Medicine, Lariboisière University Hospital, AP-HP University Paris Diderot, Paris, France; Cardiac Diseases and Biomarkers, INSERM UMR 942, Lariboisière University Hospital Paris, France
| | - Marie Tomandlova
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Milan Dastych
- Department of Biochemistry, University Hospital Brno, Brno, Czech Republic; Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jana Gottwaldova
- Department of Biochemistry, University Hospital Brno, Brno, Czech Republic; Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Etienne Gayat
- Department of Anaesthesiology and Critical Care Medicine, Lariboisière University Hospital, AP-HP University Paris Diderot, Paris, France; Cardiac Diseases and Biomarkers, INSERM UMR 942, Lariboisière University Hospital Paris, France
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14
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Winter R, Fazlinezhad A, Martins Fernandes S, Pellegrino M, Iriart X, Moustafa S, Stolfo D, Bieseviciene M, Patel S, Vriz O, Sarvari SI, Santos M, Berezin A, Stoebe S, Benyounes Iglesias N, De Chiara B, Soliman A, Oni O, Ricci F, Tumasyan LR, Kim KH, Popa BA, Yiangou K, Olsen RH, Cacicedo A, Monti L, Holte E, Orlic D, Trifunovic D, Nucifora G, Casalta AC, Cavalcante JL, Keramida K, Calin A, Almeida Morais L, Bandera F, Galli E, Kamal HM, Leite L, Polte CL, Martinez Santos P, Jin CN, Generati G, Reali M, Kalcik M, Cacicedo A, Nascimento H, Ferreiro Quero C, Kazum S, Madeira S, Villagra JM, Muraru D, Gobbo M, Generati G, D'andrea A, Azevedo O, Nucifora G, Cruz I, Lozano Granero VC, Stampfli SF, Marketou M, Bento D, Mohty D, Hernandez Jimenez V, Gascuena R, Ingvarsson A, Cameli M, Werther Evaldsson A, Greiner S, Michelsen MM, El Eraky AZZA, Kamal HM, D'ascenzi F, Spinelli L, Stojanovic S, Mincu RI, Vindis D, Mantovani F, Yi JE, Styczynski G, Battah AHMED, O'driscoll J, Generati G, Velasco Del Castillo S, Voilliot D, Scali MC, Garcia Campos A, Opitz B, Herold IHF, Veiga CESAR, Santos Furtado M, Khan UM, Leite L, Leite L, Leite L, Keramida K, Molnar AA, Rio P, Huang MS, Papadopoulos C, Venneri L, Onut R, Casas Rojo E, Bayat F, Aggeli C, Ben Kahla S, Abid L, Choi JH, Barreiro Perez M, Lindqvist P, Sheehan F, Vojdanparast M, Nezafati P, Teixeira R, Generati G, Bandera F, Labate V, Alfonzetti E, Guazzi M, Dinet ML, Jalal Z, Cochet H, Thambo JB, Ho TH, Shah P, Murphy K, Nelluri BK, Lee H, Wilansky S, Mookadam F, Tonet E, Merlo M, Barbati G, Gigli M, Pinamonti B, Ramani F, Zecchin M, Sinagra G, Vaskelyte JJ, Mizariene V, Lesauskaite V, Verseckaite R, Karaliute R, Jonkaitiene R, Li L, Craft M, Danford D, Kutty S, Pellegrinet M, Zito C, Carerj S, Di Bello V, Cittadini A, Bossone E, Antonini-Canterin F, Rodriguez M, Sitges M, Sepulveda-Martinez A, Gratacos E, Bijnens B, Crispi F, Leite L, Martins R, Baptista R, Barbosa A, Ribeiro N, Oliveira A, Castro G, Pego M, Samura T, Kremzer A, Tarr A, Pfeiffer D, Hagendorff A, Van Der Vynckt C, Gout O, Devys JM, Cohen A, Musca F, D'angelo L, Cipriani MG, Parolini M, Rossi A, Santambrogio GM, Russo C, Giannattasio C, Moreo A, Moharram M, Gamal A, Reda A, Adebiyi A, Aje A, Aquilani R, Dipace G, Bucciarelli V, Bianco F, Miniero E, Scipioni G, De Caterina R, Gallina S, Adamyan KG, Chilingaryan AL, Tunyan LG, Cho JY, Yoon HJ, Ahn Y, Jeong MH, Cho JG, Park JC, Popa A, Cerin G, Azina CH, Yiangou A, Georgiou C, Zitti M, Ioannides M, Chimonides S, Pedersen LR, Snoer M, Christensen TE, Ghotbi AA, Hasbak P, Kjaer A, Haugaard SB, Prescott E, Velasco Del Castillo S, Gomez Sanchez V, Anton Ladislao A, Onaindia Gandarias J, Rodriguez Sanchez I, Jimenez Melo O, Garcia Cuenca E, Zugazabeitia Irazabal G, Romero Pereiro A, Nardi B, Di Giovine G, Malanchini G, Scardino C, Balzarini L, Presbitero P, Gasparini GL, Tesic M, Zamaklar-Trifunovic D, Vujisic-Tesic B, Borovic M, Milasinovic D, Zivkovic M, Kostic J, Belelsin B, Ostojic M, Krljanac G, Savic L, Asanin M, Aleksandric S, Petrovic M, Zlatic N, Lasica R, Mrdovic I, Muser D, Zanuttini D, Tioni C, Bernardi G, Spedicato L, Proclemer A, Galli E, Szymanski C, Salaun E, Lavoute C, Haentjens J, Tribouilloy C, Mancini J, Donal E, Habib G, Delgado-Montero A, Dahou A, Caballero L, Rijal S, Gorcsan J, Monin JL, Pibarot P, Lancellotti P, Kouris N, Kostopoulos V, Giannaris V, Trifou E, Markos L, Mihalopoulos A, Mprempos G, Olympios CD, Mateescu AD, Rosca M, Beladan CC, Enache R, Gurzun MM, Varga P, Calin C, Ginghina C, Popescu BA, Galrinho A, Branco L, Gomes V, Timoteo AT, Daniel P, Rodrigues I, Rosa S, Fragata J, Ferreira R, Generati G, Pellegrino M, Carbone F, Labate V, Alfonzetti E, Guazzi M, Leclercq C, Samset E, Donal E, Oraby MA, Eleraky AZ, Yossuef MA, Baptista R, Teixeira R, Ribeiro N, Oliveira AP, Barbosa A, Castro G, Martins R, Elvas L, Pego M, Gao SA, Lagerstrand KM, Johnsson ÅA, Bech-Hanssen O, Vilacosta I, Batlle Lopez E, Sanchez Sauce B, Jimenez Valtierra J, Espana Barrio E, Campuzano Ruiz R, De La Rosa Riestra A, Alonso Bello J, Perez Gonzalez F, Wan S, Sun JP, Lee AP, Bandera F, Pellegrino M, Carbone F, Labate V, Alfonzetti E, Guazzi M, Cimino S, Salatino T, Silvetti E, Mancone M, Pennacchi M, Giordano A, Sardella G, Agati L, Yesin M, Gunduz S, Gursoy MO, Astarcioglu MA, Karakoyun S, Bayam E, Cersit S, Ozkan M, Velasco Del Castillo S, Gomez Sanchez V, Anton Ladislao A, Onaindia Gandarias J, Rodriguez Sanchez I, Jimenez Melo O, Quintana Razcka O, Romero Pereiro A, Zugazabeitia Irazabal G, Braga M, Flores L, Ribeiro V, Melao F, Dias P, Maciel MJ, Bettencourt P, Mesa Rubio MD, Ruiz Ortiz M, Delgado Ortega M, Sanchez Fernandez J, Duran Jimenez E, Morenate Navio C, Romero M, Pan M, Suarez De Lezo J, Vaturi M, Weisenberg D, Monakier D, Valdman A, Vaknin- Assa H, Assali A, Kornowski R, Sagie A, Shapira Y, Ribeiras R, Abecasis J, Teles R, Castro M, Tralhao A, Horta E, Brito J, Andrade M, Mendes M, Avegliano G, Ronderos R, Matta MG, Camporrotondo M, Castro F, Albina G, Aranda A, Navia D, Siciliano M, Migliore F, Cavedon S, Folino F, Pedrizzetti G, Bertaglia M, Corrado D, Iliceto S, Badano LP, Merlo M, Stolfo D, Losurdo P, Ramani F, Barbati G, Pivetta A, Pinamonti B, Sinagra GF, Di Lenarda A, Bandera F, Pellegrino M, Labate V, Carbone F, Alfonzetti E, Guazzi M, Di Palma E, Baldini L, Verrengia M, Vastarella R, Limongelli G, Bossone E, Calabro' R, Russo MG, Pacileo G, Cruz I, Correia E, Bento D, Teles L, Lourenco C, Faria R, Domingues K, Picarra B, Marques N, Muser D, Gianfagna P, Morocutti G, Proclemer A, Gomes AC, Lopes LR, Stuart B, Caldeira D, Morgado G, Almeida AR, Canedo P, Bagulho C, Pereira H, Pardo Sanz A, Marco Del Castillo A, Monteagudo Ruiz JM, Rincon Diaz LM, Ruiz Rejon F, Casas E, Hinojar R, Fernandez-Golfin C, Zamorano Gomez JL, Erhart L, Staehli BE, Kaufmann BA, Tanner FC, Kontaraki J, Parthenakis F, Maragkoudakis S, Zacharis E, Patrianakos A, Vardas P, Domingues K, Correia E, Lopes L, Teles L, Picarra B, Magalhaes P, Faria R, Lourenco C, Azevedo O, Boulogne C, Magne J, Damy T, Martin S, Boncoeur MP, Aboyans V, Jaccard A, Saavedra Falero J, Alberca Vela MT, Molina Blazquez L, Mata Caballero R, Serrano Rosado JA, Elviro R, Di Gioia C, Fernandez Rozas I, Manzano MC, Martinez Sanchez JI, Molina M, Palma J, Werther Evaldsson A, Radegran G, Stagmo M, Waktare J, Roijer A, Meurling CJ, Righini FM, Sparla S, Di Tommaso C, Focardi M, D'ascenzi F, Tacchini D, Maccherini M, Henein M, Mondillo S, Ingvarsson A, Waktare J, Thilen U, Stagmo M, Roijer A, Radegran G, Meurling C, Jud A, Aurich M, Katus HA, Mereles D, Faber R, Pena A, Mygind ND, Suhrs HE, Zander M, Prescott E, Handoka NESRIN, Ghali MONA, Eldahshan NAHED, Ibrahim AHMED, Al-Eraky AZ, El Attar MA, Omar AS, Pelliccia A, Alvino F, Solari M, Cameli M, Focardi M, Bonifazi M, Mondillo S, Giudice CA, Assante Di Panzillo E, Castaldo D, Riccio E, Pisani A, Trimarco B, Deljanin Ilic M, Ilic S, Magda LS, Florescu M, Velcea A, Mihalcea D, Chiru A, Popescu BO, Tiu C, Vinereanu D, Hutyra M, Cechakova E, Littnerova S, Taborsky M, Lugli R, Bursi F, Fabbri M, Modena MG, Stefanelli G, Mussini C, Barbieri A, Youn HJ, O JH, Yoon HJ, Jung HO, Shin GJ, Rdzanek A, Pietrasik A, Kochman J, Huczek Z, Milewska A, Marczewska M, Szmigielski CA, Abd Eldayem SOHA, El Magd El Bohy ABO, Slee A, Peresso V, Nazir S, Sharma R, Bandera F, Pellegrino M, Labate V, Carbone F, Alfonzetti E, Guazzi M, Anton Ladislao A, Gomez Sanchez V, Cacidedo Fernandez Bobadilla A, Onaindia Gandarias JJ, Rodriguez Sanchez I, Romero Pereira A, Quintana Rackza O, Jimenez Melo O, Zugazabeitia Irazabal G, Huttin O, Venner C, Deballon R, Manenti V, Villemin T, Olivier A, Sadoul N, Juilliere Y, Selton-Suty C, Simioniuc A, Mandoli GE, Dini FL, Marzilli M, Picano E, Martin-Fernandez M, De La Hera Galarza JM, Corros-Vicente C, Leon-Aguero V, Velasco-Alonso E, Colunga-Blanco S, Fidalgo-Arguelles A, Rozado-Castano J, Moris De La Tassa C, Stelzmueller ME, Wisser W, Reichenfelser W, Mohl W, Saporito S, Mischi M, Bouwman RA, Van Assen HC, Van Den Bosch HCM, De Lepper A, Korsten HHM, Houthuizen P, Rodrigues A, Leal G, Silvestre O, Andrade J, Hjertaas JJ, Greve G, Matre K, Teixeira R, Baptista R, Barbosa A, Ribeiro N, Castro G, Martins R, Cardim N, Goncalves L, Pego M, Teixeira R, Baptista R, Barbosa A, Ribeiro N, Castro G, Martins R, Cardim N, Goncalves L, Pego M, Teixeira R, Baptista R, Barbosa A, Oliveira AP, Castro G, Martins R, Cardim N, Goncalves L, Pego M, Kouris N, Kostopoulos V, Markos L, Olympios CD, Kovacs A, Tarnoki AD, Tarnoki DL, Kolossvary M, Apor A, Maurovich-Horvat P, Jermendy G, Sengupta P, Merkely B, Viveiros Monteiro A, Galrinho A, Pereira-Da-Silva T, Moura Branco L, Timoteo A, Abreu J, Leal A, Varela F, Cruz Ferreira R, Yang LT, Tsai WC, Mpaltoumas K, Fotoglidis A, Triantafyllou K, Pagourelias E, Kassimatis E, Tzikas S, Kotsiouros G, Mantzogeorgou E, Vassilikos V, Calicchio F, Manivarmane R, Pareek N, Baksi J, Rosen S, Senior R, Lyon AR, Khattar RS, Marinescu C, Onciul S, Zamfir D, Tautu O, Dorobantu M, Carbonell San Roman A, Rincon Diez LM, Gonzalez Gomez A, Fernandez Santos S, Lazaro Rivera C, Moreno Vinues C, Sanmartin Fernandez M, Fernandez-Golfin C, Zamorano Gomez JL, Alirezaei T, Karimi AS, Kakiouzi V, Felekos I, Panagopoulou V, Latsios G, Karabela M, Petras D, Tousoulis D, Abid L, Abid D, Kammoun S, Ben Kahla S, Lee JW, Martin Fernandez M, Costilla Garcia SM, Diaz Pelaez E, Moris De La Tassa C. Poster session 3The imaging examinationP646Simulator-based testing of skill in transthoracic echoP647Clinical and echocardiographic characteristics of isolated left ventricular non-compactionP648Appropriate use criteria of transthoracic echocardiography and its clinical impact in an aged populationAnatomy and physiology of the heart and great vesselsP649Prevalence and determinants of exercise oscillatory ventilation in the EUROEX trial populationAssessment of diameters, volumes and massP650Left atrial remodeling after percutaneous left atrial appendage closureP651Global atrial performance with tyrosine kinase inhibitors in metastatic renal cell carcinomaP652Early right ventricular response to cardiac resynchronization therapy: impact on clinical outcomesP653Parameters of speckle-tracking echocardiography and biomechanical values of a dilative ascending aortaAssessments of haemodynamicsP654Right atrial hemodynamics in infants and children: observations from 3-dimensional echocardiography derived right atrial volumesAssessment of systolic functionP655One-point carotid wave intensity predicts cardiac mortality in patients with congestive heart failure and reduced ejection fractionP656Persistence of cardiac remodeling in adolescents with previous fetal growth restrictionP6572D speckle tracking-derived left ventricle global longitudinal strain and left ventricular dysfunction stages: a useful discriminator in moderate-to-severe aortic regurgitationP658Global longitudinal strain and strain rate in type two diabetes patients with chronic heart failure: relevance to circulating osteoprotegerinP659Analysis of left ventricular function in patients before and after surgical and interventional mitral valve therapyP660Left ventricular end-diastolic volume is complementary with global longitudinal strain for the prediction of left ventricular ejection fraction in echocardiographic daily practiceP661Left ventricular assist device, right ventricle function, and selection bias: the light side of the moonP662Assessment of right ventricular function in patients with anterior ST elevation myocardial infarction; a 2-d speckle tracking studyP663Right ventricular systolic function assessment in sickle cell anaemia using echocardiographyAssessment of diastolic functionP664Prognostic value of transthoracic cardiopulmonary ultrasound in cardiac surgery intensive care unitP665Comparative efficacy of renin-angiotensin system modulators on prognosis, right heart and left atrial parameters in patients with chronic heart failure and preserved left ventricular systolic functionP666Left atrial volume index is the most significant diastolic functional parameter of hemodynamic burden as measured by NT-proBNP in acute myocardial infarctionP667Preventive echocardiographic screening. preliminary dataP668Assessment of the atrial electromechanical delay and the mechanical functions of the left atrium in patients with diabetes mellitus type IIschemic heart diseaseP669Coronary flow velocity reserve by echocardiography as a measure of microvascular function: feasibility, reproducibility and agreement with PET in overweight patients with coronary artery diseaseP670Influence of cardiovascular risk in the occurrence of events in patients with negative stress echocardiographyP671Prevalence of transmural myocardial infarction and viable myocardium in chronic total occlusion (CTO) patientsP672The impact of the interleukin 6 receptor antagonist tocilizumab on mircovascular dysfunction after non st elevation myocardial infarction assessed by coronary flow reserve from a randomized studyP673Impact of manual thrombus aspiration on left ventricular remodeling: the echocardiographic substudy of the randomized Physiologic Assessment of Thrombus Aspirtion in patients with ST-segment ElevatioP674Acute heart failure in STEMI patients treated with primary percutaneous coronary intervention is related to transmural circumferential myocardial strainP675Long-term prognostic value of infarct size as assessed by cardiac magnetic resonance imaging after a first st-segment elevation myocardial infarctionHeart valve DiseasesP676Prognostic value of LV global longitudinal strain in aortic stenosis with preserved LV ejection fractionP677Importance of longitudinal dyssynchrony in low flow low gradient severe aortic stenosis patients undergoing dobutamine stress echocardiography. a multicenter study (on behalf of the HAVEC group)P678Predictive value of left ventricular longitudinal strain by 2D Speckle Tracking echocardiography, in asymptomatic patients with severe aortic stenosis and preserved ejection fractionP679Clinical and echocardiographic characteristics of the flow-gradient patterns in patients with severe aortic stenosis and preserved left ventricular ejection fractionP6802D and 3D speckle tracking assessment of left ventricular function in severe aortic stenosis, a step further from biplane ejection fractionP681Functional evaluation in aortic stenosis: determinant of exercise capacityP682Left ventricular mechanics: novel tools to evaluate left ventricular function in patients with primary mitral regurgitationP683Plasma B-type natriuretic peptide level in patients with isolated rheumatic mitral stenosisP684Quantitative assessment of severity in aortic regurgitation and the influence of elastic proprieties of thoracic aortaP685Characterization of chronic aortic and mitral regurgitation using cardiovascular magnetic resonanceP686Functional mitral regurgitation: a warning sign of underlying left ventricular systolic dysfunction in heart failure with preserved ejection fraction.P687Secondary mitral valve tenting in primary degenerative prolapse quantified by three-dimensional echocardiography predicts regurgitation recurrence after mitral valve repairP688Advanced heart failure with reduced ejection fraction and severe mitral insufficiency compensate with a higher oxygen peripheral extraction to a reduced cardiac output vs oxygen uptake response to maxP689Predictors of acute procedural success after percutaneous mitraclip implantation in patients with moderate-to-severe or severe mitral regurgitation and reduced ejection fractionP690The value of transvalvular gradients obtained by transthoracic echocardiography in estimation of severe paravalvular leakage in patients with mitral prosthetic valvesP691Characteristics of infective endocarditis in a non tertiary hospitalP692Infective endocarditis: predictors of severity in a 3-year retrospective analysisP693New echocardiographic predictors of early recurrent mitral functional regurgitation after mitraclip implantationP694Transesophageal echocardiography can be reliably used for the allocation of patients with severe aortic stenosis for tras-catheter aortic valve implantationP695Annular sizing for transcatheter aortic valve selection. A comparison between computed tomography and 3D echocardiographyP696Association between aortic dilatation, mitral valve prolapse and atrial septal aneurysm: first descriptive study.CardiomyopathiesP698Cardiac resynchronization therapy by multipoint pacing improves the acute response of left ventricular mechanics and fluid dynamics: a three-dimensional and particle image velocimetry echo studyP699Long-term natural history of right ventricular function in dilated cardiomyopathy: innocent bystander or leading actor?P700Right to left ventricular interdependence at rest and during exercise assessed by the ratio between pulmonary systolic to diastolic time in heart failure reduced ejection fractionP701Exercise strain imaging demonstrates impaired right ventricular contractile reserve in patients with hypertrophic cardiomyopathyP702Prevalence of overt left ventricular dysfunction (burn-out phase) in a portuguese population of hypertrophic cardiomyopathy, a multicentre studyP703Systolic and diastolic myocardial mechanics in hypertrophic cardiomyopathy and their link to the extent of hypertrophy, replacement fibrosis and interstitial fibrosisP704Multimodality imaging and genotype-phenotype associations in a cohort of patients with hypertrophic cardiomyopathy studied by next generation sequencing and cardiac magnetic resonanceP705Sudden cardiac death risk assessment in apical hypertrophic cardiomyopathy: do we need to add MRI to the equation?P706Prognostic value of left ventricular ejection fraction, proBNP, exercise capacity, and NYHA functional class in patients with left ventricular non-compaction cardiomyopathyP707The anti-hypertrophic microRNAs miR-1, miR-133a and miR-26b and their relationship to left ventricular hypertrophy in patients with essential hypertensionP708Prevalence of left ventricular systolic dysfunction in a portuguese population of left ventricular non-compaction cardiomyopathy, a multicentre studyP709Assessment of systolic and diastolic features in light chain amyloidosis: an echocardiographic and cardiac magnetic resonance studyP710Morbid obesity-associated hypertension identifies bariatric surgery best responders: Clinical and echocardiographic follow up studyP711Echocardiographic markera for overhydration in patients under haemodialysisP712Gender aspects of right ventricular size and function in clinically stable heart transplant patientsP713Evidence of cardiac stem cells from the left ventricular apical tip in patients undergone LVAD implant: a comparative strain-ultrastructural studySystemic diseases and other conditionsP714Speckle tracking assessment of right ventricular function is superior for differentiation of pressure versus volume overloaded right ventricleP715Prognostic value of pulmonary arterial pressure: analysis in a large dataset of timely matched non-invasive and invasive assessmentsP716Effect of the glucagon-like peptide-1 analogue liraglutide on left ventricular diastolic and systolic function in patients with type 2 diabetes: a randomised, single-blinded, crossover pilot studyP717Tissue doppler evaluation of left ventricular functions, left atrial mechanical functions and atrial electromechanical delay in juvenile idiopathic arthritisP718Echocardiographic detection of subclinical left ventricular dysfunction in patients with rheumatoid arthritisP719Left ventricular strain values are unaffected by intense training: a longitudinal, speckle-tracking studyP720Diastolic left ventricular function in autosomal dominant polycystic kidney disease: a matched-cohort, speckle-tracking echocardiographic studyP721Relationship between adiponectin level and left ventricular mass and functionP722Left atrial function is impaired in patients with multiple sclerosisMasses, tumors and sources of embolismP723Paradoxical embolization to the brain in patients with acute pulmonary embolism and confirmed patent foramen ovale with bidirectional shunt, results of prospective monitoringP724Following the European Society of Cardiology proposed echocardiographic algorithm in elective patients with clinical suspicion of infective endocarditis: diagnostic yield and prognostic implicationsP725Metastatic cardiac18F-FDG uptake in patients with malignancy: comparison with echocardiographic findingsDiseases of the aortaP726Echocardiographic measurements of aortic pulse wave velocity correlate well with invasive methodP727Assessment of increase in aortic and carotid intimal medial thickness in adolescent type 1 diabetic patientsStress echocardiographyP728Determinants and prognostic significance of heart rate variability in renal transplant candidates undergoing dobutamine stress echocardiographyP729Pattern of cardiac output vs O2 uptake ratio during maximal exercise in heart failure with reduced ejection fraction: pathophysiological insightsP730Prognostic value and predictive factors of cardiac events in patients with normal exercise echocardiographyP731Right ventricular mechanics during exercise echocardiography: normal values, feasibility and reproducibility of conventional and new right ventricular function parametersP732The added value of exercise-echo in heart failure patients: assessing dynamic changes in extravascular lung waterP733Applicability of appropriate use criteria of exercise stress echocardiography in real-life practice: what have we improved with new documents?Transesophageal echocardiographyP7343D-TEE guidance in percutaneous mitral valve interventions correcting mitral regurgitationContrast echocardiographyP735Pulmonary transit time by contrast enhanced ultrasound as parameter for cardiac performance: a comparison with magnetic resonance imaging and NT-ProBNPReal-time three-dimensional TEEP736Optimal parameter selection for anisotropic diffusion denoising filters applied to aortic valve 4d echocardiographsP737Left ventricle systolic function in non-alcoholic cirrhotic candidates for liver transplantation: a three-dimensional speckle-tracking echocardiography studyTissue Doppler and speckle trackingP738Optimizing speckle tracking echocardiography strain measurements in infants: an in-vitro phantom studyP739Usefulness of vascular mechanics in aortic degenerative valve disease to estimate prognosis: a two dimensional speckle tracking studyP740Vascular mechanics in aortic degenerative valve disease: a two dimensional speckle-tracking echocardiography studyP741Statins and vascular load in aortic valve disease patients, a speckle tracking echocardiography studyP742Is Left Bundle Branch Block only an electrocardiographic abnormality? Study of LV function by 2D speckle tracking in patients with normal ejection fractionP743Dominant inheritance of global longitudinal strain in a population of healthy and hypertensive twinsP744Mechanical differences of left atria in paroxysmal atrial fibrillation: A speckle-tracking study.P745Different distribution of myocardial deformation between hypertrophic cardiomyopathy and aortic stenosisP746Left atrial mechanics in patients with chronic renal failure. Incremental value for atrial fibrillation predictionP747Subclinical myocardial dysfunction in cancer patients: is there a direct effect of tumour growth?P748The abnormal global longitudinal strain predicts significant circumflex artery disease in low risk acute coronary syndromeP7493D-Speckle tracking echocardiography for assessing ventricular funcion and infarct size in young patients after acute coronary syndromeP750Evaluation of left ventricular dyssynchrony by echocardiograhy in patients with type 2 diabetes mellitus without clinically evident cardiac diseaseP751Differences in myocardial function between peritoneal dialysis and hemodialysis patients: insights from speckle tracking echoP752Appraisal of left atrium changes in hypertensive heart disease: insights from a speckle tracking studyP753Left ventricular rotational behavior in hypertensive patients: Two dimensional speckle tracking imaging studyComputed Tomography & Nuclear CardiologyP754Effectiveness of adaptive statistical iterative reconstruction of 64-slice dual-energy ct pulmonary angiography in the patients with reduced iodine load: comparison with standard ct pulmonary angiograP755Clinical prediction model to inconclusive result assessed by coronary computed tomography angiography. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Helanova K, Littnerova S, Kubena P, Ganovska E, Pavlusova M, Kubkova L, Jarkovsky J, Pavkova Goldbergova M, Lipkova J, Gottwaldova J, Kala P, Toman O, Dastych M, Spinar J, Parenica J. Prognostic impact of neutrophil gelatinase-associated lipocalin and B-type natriuretic in patients with ST-elevation myocardial infarction treated by primary PCI: a prospective observational cohort study. BMJ Open 2015; 5:e006872. [PMID: 26438132 PMCID: PMC4606420 DOI: 10.1136/bmjopen-2014-006872] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Neutrophil gelatinase-associated lipocalin (NGAL) from a pathophysiological perspective connects various pathways that affect the prognosis after myocardial infarction. The objective was to evaluate the benefits of measuring NGAL for prognostic stratification in addition to the Thrombolysis in Myocardial Infarction (TIMI) score, and to compare it with the prognostic value of B-type natriuretic peptide (BNP). DESIGN Prospective observational cohort study. SETTING One university/tertiary centre. PARTICIPANTS A total of 673 patients with ST segment elevation myocardial infarction were treated by primary percutaneous coronary intervention. NGAL and BNP were assessed on hospital admission. PRIMARY OUTCOME 1-year mortality. SECONDARY OUTCOMES 1-year hospitalisation due to acute heart failure, unplanned revascularisation, reinfarction, stroke and combined end point of 1-year mortality and hospitalisation due to heart failure. STATISTICAL METHODS Using the c-statistic, the ability of NGAL, BNP and TIMI score to predict 1-year mortality alone and in combination with readmission for heart failure was evaluated. The addition of the predictive value of biomarkers to the score was assessed by category free net reclassification improvement (cfNRI) and the integrated discrimination index (IDI). RESULTS The NGAL level was significantly higher in non-survivors (67 vs 115 pg/mL; p<0.001). The area under the curve (AUC) values for mortality prediction for NGAL, BNP and TIMI score were 75.5, 78.7 and 74.4, respectively (all p<0.001) with optimal cut-off values of 84 pg/mL for NGAL and 150 pg/mL for BNP. The addition of NGAL and BNP to the TIMI score significantly improved risk stratification according to cfNRI and IDI. A BNP and the combination of the TIMI score with NGAL predicted the occurrence of the combined end point with an AUC of 80.6 or 82.2, respectively. NGAL alone is a simple tool to identify very high-risk patients. NGAL >110 pg/mL was associated with a 1-year mortality of 20%. CONCLUSIONS The measurement of NGAL together with the TIMI score results in a strong prognostic model for the 1-year mortality rate in patients with STEMI.
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Affiliation(s)
- Katerina Helanova
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Petr Kubena
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Eva Ganovska
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Marie Pavlusova
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Lenka Kubkova
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | | | - Jolana Lipkova
- Faculty of Medicine, Institute of Pathological Physiology, Masaryk University, Brno, Czech Republic
| | - Jana Gottwaldova
- Department of Biochemistry, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Department of Laboratory Methods, Masaryk University, Brno, Czech Republic
| | - Petr Kala
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Ondrej Toman
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
- Department of Cardiovascular Disease, International Clinical Research Center –University Hospital St Anne's, Brno, Czech Republic
| | - Milan Dastych
- Department of Biochemistry, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Department of Laboratory Methods, Masaryk University, Brno, Czech Republic
| | - Jindrich Spinar
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
- Department of Cardiovascular Disease, International Clinical Research Center –University Hospital St Anne's, Brno, Czech Republic
| | - Jiri Parenica
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
- Department of Cardiovascular Disease, International Clinical Research Center –University Hospital St Anne's, Brno, Czech Republic
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Vyskocilova K, Spinarova L, Spinar J, Mikusova T, Vitovec J, Malek J, Malek F, Linhart A, Fedorco M, Widimsky P, Cihalik C, Parenica J, Littnerova S, Jarkovsky J. Prevalence and clinical significance of liver function abnormalities in patients with acute heart failure. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 159:429-36. [DOI: 10.5507/bp.2014.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 03/04/2014] [Indexed: 01/27/2023] Open
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Spinar J, Jarkovsky J, Spinarova L, Mebazaa A, Gayat E, Vitovec J, Linhart A, Widimsky P, Miklik R, Zeman K, Belohlavek J, Malek F, Felsoci M, Kettner J, Ostadal P, Cihalik C, Vaclavik J, Taborsky M, Dusek L, Littnerova S, Parenica J. AHEAD score--Long-term risk classification in acute heart failure. Int J Cardiol 2015; 202:21-6. [PMID: 26386914 DOI: 10.1016/j.ijcard.2015.08.187] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 08/22/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND The role of co-morbidities in the prognosis of patients hospitalized for AHF was examined using the AHEAD (A--atrial fibrillation, H--haemoglobin<130 g/l for men and 120 g/l for women (anaemia), E--elderly (age>70years), A--abnormal renal parameters (creatinine>130 μmol/l), D--diabetes mellitus) scoring system. METHODS AHEAD--multicentre prospective Czech registry of AHF patients; GREAT registry--international cohort of AHF patients. Data from 5846 consecutive patients hospitalized for AHF (AHEAD registry; derivation cohort) were analysed to build the AHEAD score. Each risk factor of the AHEAD score was counted as 1 point. The model was validated externally using an international cohort of similar patients in the GREAT registry (6315). RESULTS Main outcome was one year all-cause mortality. The mean age of patients was 72±12 years, with 61.6% of patients aged >70 years; 43.4% were women. Atrial fibrillation was present in 30.7%, anaemia in 38.2%, creatinine>130 mmol/l (abnormal renal parameters) in 30.1%, and diabetes mellitus in 44.0%. The mean AHEAD score was 2.1. In patients with AHEAD scores of 0-5, the one-year mortality rates were 13.6%, 23.4%, 32.0%, 41.1%, 47.7%, and 58.2%, respectively (p<0.001), and the 90 month mortality rates were 35.1%, 57.3%, 73.5%, 84.8%, 88.0%, and 91.7%, respectively (p<0.001). CONCLUSION The AHEAD is a simple scoring system based on the analysis of co-morbidities for the estimation of the short and long term prognosis of patients hospitalized for AHF.
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Affiliation(s)
- Jindrich Spinar
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lenka Spinarova
- Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic
| | - Alexandre Mebazaa
- Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisiere University Hospital, Paris, France; UMR-S 942, Inserm, Paris, France
| | - Etienne Gayat
- Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisiere University Hospital, Paris, France; UMR-S 942, Inserm, Paris, France
| | - Jiri Vitovec
- Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic
| | - Ales Linhart
- 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic
| | - Petr Widimsky
- Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Roman Miklik
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic
| | - Kamil Zeman
- Department of Internal Medicine, Hospital Frydek-Mistek, Frydek-Mistek, Czech Republic
| | - Jan Belohlavek
- 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic
| | - Filip Malek
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Marian Felsoci
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic
| | - Jiri Kettner
- Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petr Ostadal
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Cestmir Cihalik
- Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Jan Vaclavik
- Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Miloš Taborsky
- Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Ladislav Dusek
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Parenica
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic.
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Kluz K, Parenica J, Kubkova L, Littnerova S, Tomandl J, Poloczek M, Toman O, Tesak M, Cermakova Z, Gottwaldova J, Manousek J, Pavkova Goldbergova M, Spinar J, Jarkovsky J. Unstable angina pectoris prior to ST elevation myocardial infarction in patients treated with primary percutaneous coronary intervention has no influence on prognosis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015; 159:251-8. [DOI: 10.5507/bp.2014.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 01/14/2014] [Indexed: 11/23/2022] Open
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Littnerova S, Kala P, Jarkovsky J, Kubkova L, Prymusova K, Kubena P, Tesak M, Toman O, Poloczek M, Spinar J, Dusek L, Parenica J. GRACE Score among Six Risk Scoring Systems (CADILLAC, PAMI, TIMI, Dynamic TIMI, Zwolle) Demonstrated the Best Predictive Value for Prediction of Long-Term Mortality in Patients with ST-Elevation Myocardial Infarction. PLoS One 2015; 10:e0123215. [PMID: 25893501 PMCID: PMC4404322 DOI: 10.1371/journal.pone.0123215] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 03/01/2015] [Indexed: 12/22/2022] Open
Abstract
AIM To compare the prognostic accuracy of six scoring models for up to three-year mortality and rates of hospitalisation due to acute decompensated heart failure (ADHF) in STEMI patients. METHODS AND RESULTS A total of 593 patients treated with primary PCI were evaluated. Prospective follow-up of patients was ≥3 years. Thirty-day, one-year, two-year, and three-year mortality rates were 4.0%, 7.3%, 8.9%, and 10.6%, respectively. Six risk scores--the TIMI score and derived dynamic TIMI, CADILLAC, PAMI, Zwolle, and GRACE--showed a high predictive accuracy for six- and 12-month mortality with area under the receiver operating characteristic curve (AUC) values of 0.73-0.85. The best predictive values for long-term mortality were obtained by GRACE. The next best-performing scores were CADILLAC, Zwolle, and Dynamic TIMI. All risk scores had a lower prediction accuracy for repeat hospitalisation due to ADHF, except Zwolle with the discriminatory capacity for hospitalisation up to two years (AUC, 0.80-0.83). CONCLUSIONS All tested models showed a high predictive value for the estimation of one-year mortality, but GRACE appears to be the most suitable for the prediction for a longer follow-up period. The tested models exhibited an ability to predict the risk of ADHF, especially the Zwolle model.
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Affiliation(s)
- Simona Littnerova
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Petr Kala
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
- * E-mail:
| | - Lenka Kubkova
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Center–Department of Cardiovascular Disease, St Anne’s University Hospital, Brno, Czech Republic
| | - Krystyna Prymusova
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Hospital Podlesi A.S., Trinec, Czech Republic
| | - Petr Kubena
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martin Tesak
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Hospital Trebic, Trebic, Czech Republic
| | - Ondrej Toman
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- International Clinical Research Center–Department of Cardiovascular Disease, St Anne’s University Hospital, Brno, Czech Republic
| | - Martin Poloczek
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jindrich Spinar
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Center–Department of Cardiovascular Disease, St Anne’s University Hospital, Brno, Czech Republic
| | - Ladislav Dusek
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Jiri Parenica
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Center–Department of Cardiovascular Disease, St Anne’s University Hospital, Brno, Czech Republic
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Littnerova S, Parenica J, Spinar J, Vitovec J, Linhart A, Widimsky P, Jarkovsky J, Miklik R, Spinarova L, Zeman K, Belohlavek J, Malek F, Felsoci M, Kettner J, Ostadal P, Cihalik C, Spac J, Al-Hiti H, Fedorco M, Fojt R, Kruger A, Malek J, Mikusová T, Monhart Z, Bohacova S, Pohludkova L, Rohac F, Vaclavik J, Vondrakova D, Vyskocilova K, Bambuch M, Dusek L. Positive influence of being overweight/obese on long term survival in patients hospitalised due to acute heart failure. PLoS One 2015; 10:e0117142. [PMID: 25710625 PMCID: PMC4339191 DOI: 10.1371/journal.pone.0117142] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/19/2014] [Indexed: 11/28/2022] Open
Abstract
Background Obesity is clearly associated with increased morbidity and mortality rates. However, in patients with acute heart failure (AHF), an increased BMI could represent a protective marker. Studies evaluating the “obesity paradox” on a large cohort with long-term follow-up are lacking. Methods Using the AHEAD database (a Czech multi-centre database of patients hospitalised due to AHF), 5057 patients were evaluated; patients with a BMI <18.5 kg/m2 were excluded. All-cause mortality was compared between groups with a BMI of 18.5–25 kg/m2 and with BMI >25 kg/m2. Data were adjusted by a propensity score for 11 parameters. Results In the balanced groups, the difference in 30-day mortality was not significant. The long-term mortality of patients with normal weight was higher than for those who were overweight/obese (HR, 1.36; 95% CI, 1.26–1.48; p<0.001)). In the balanced dataset, the pattern was similar (1.22; 1.09–1.39; p<0.001). A similar result was found in the balanced dataset of a subgroup of patients with de novo AHF (1.30; 1.11–1.52; p = 0.001), but only a trend in a balanced dataset of patients with acute decompensated heart failure. Conclusion These data suggest significantly lower long-term mortality in overweight/obese patients with AHF. The results suggest that at present there is no evidence for weight reduction in overweight/obese patients with heart failure, and emphasize the importance of prevention of cardiac cachexia.
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Affiliation(s)
- Simona Littnerova
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Parenica
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic
| | - Jindrich Spinar
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Medical Faculty, Masaryk University, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic
| | - Jirí Vitovec
- Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic
| | - Ales Linhart
- 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic
| | - Petr Widimsky
- Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Roman Miklik
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic
| | - Lenka Spinarova
- Medical Faculty, Masaryk University, Brno, Czech Republic; First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic
| | - Kamil Zeman
- Department of Internal Medicine, Hospital Frydek-Mistek, Frydek-Mistek, Czech Republic
| | - Jan Belohlavek
- 2nd Department of Cardiovascular Internal Medicine, First Medical Faculty, Charles University, Prague and General Teaching Hospital of Prague, Prague, Czech Republic
| | - Filip Malek
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Marian Felsoci
- Department of Cardiology, University Hospital Brno, Brno, Czech Republic; Department of Cardiovascular Disease, International Clinical Research Center, University Hospital St Anne's, Brno, Czech Republic
| | - Jiri Kettner
- Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petr Ostadal
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Cestmir Cihalik
- Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Jiri Spac
- Medical Faculty, Masaryk University, Brno, Czech Republic; 2nd Department of Internal Medicine, University Hospital St Anne's, Brno, Czech Republic
| | - Hikmet Al-Hiti
- Department of Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic
| | - Marian Fedorco
- Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Richard Fojt
- Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Andreas Kruger
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Josef Malek
- Department of Internal Medicine, Hospital Havlickuv Brod, Havlickuv Brod, Czech Republic
| | - Tereza Mikusová
- First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic
| | - Zdenek Monhart
- Department of Internal Medicine, Hospital Znojmo, Znojmo, Czech Republic
| | | | - Lidka Pohludkova
- Department of Internal Medicine, Hospital Frydek-Mistek, Frydek-Mistek, Czech Republic
| | - Filip Rohac
- Kralovske Vinohrady University Hospital and the 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Vaclavik
- Department of Internal Medicine, University Hospital Olomouc, Olomouc, Czech Republic
| | - Dagmar Vondrakova
- Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic
| | - Klaudia Vyskocilova
- First Department of Cardiovascular Internal Medicine, University Hospital St Anne's, Brno, Czech Republic
| | - Miroslav Bambuch
- Department of Cardiology, T.Bata Hospital Zlin, Zlin, Czech Republic
| | - Ladislav Dusek
- Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Taborsky M, Rihova D, Mraz T, Mandysova E, Vlasinova J, Kamenik L, Novak M, Neuzil P, Jarkovsky J, Littnerova S. TUGENDHAT: a pilot randomized study on effects of biventricular pacing in patients with bradycardia pacing indication and normal systolic function on heart failure, atrial fibrillation and quality of life (results of 12 month follow-up). BRATISL MED J 2013; 114:323-9. [PMID: 23731043 DOI: 10.4149/bll_2013_068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Since the late 1990s, a growing number of clinical studies have indicated that long-term permanent right ventricular (RV) apical pacing will induce severe complications such as development of heart failure, increased burden of atrial fibrillation leading to decreased quality of life. AIM OF THE STUDY To investigate whether cardiac resynchronization therapy (CRT) using biventricular (BiV) pacing can prevent the development of left ventricular (LV) dysfunction, LV remodelling, worsening of the clinical status and quality of life in chronically RV paced patients with normal LV ejection fraction (EF). METHODS AND RESULTS A total of 127 patients with Class I indication for permanent cardiac pacing and without established indication for CRT were subjected to 6 months of RV and BiV pacing in a patient-blinded, randomized crossover trial. Treatment effects of BiV pacing were evaluated for LV function, LV remodelling and clinical status. As compared with RV pacing, BiV pacing did not significantly prevent the decrease of LV function [LVEF 61.0 % (36.0; 68.0) vs 60.5 % (38.5; 67.5) in RV pacing], did not change the functional class according to the New York Heart Association [52 % in Class II vs 53.9 % in Class II in RV pacing, and 3.9 % in Class III vs 6.9 % in Class III in RV pacing], and did not present any changes in quality of life [32.5 (18.0; 80.0) vs 32.0 (21.0; 47.0) indexes in RV pacing]. CONCLUSION BiV pacing, compared to RV pacing, did not change LV function and quality of life in patients with the absence of LV dysfunction or remodelling, standard bradycardia pacing indications in a pilot phase (12- month follow-up) of the TUGENDHAT trial. The final report will be published after 60-month follow-up termination (Tab. 5, Fig. 3, Ref. 30).
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Affiliation(s)
- M Taborsky
- Department of Internal Medicine I- Cardiology, Faculty of Medicine and Dentistry, Palacky Universit Olomouc, Czech Republic.
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Parenica J, Nemec P, Tomandl J, Ondrasek J, Pavkova-Goldbergova M, Tretina M, Jarkovsky J, Littnerova S, Poloczek M, Pokorny P, Spinar J, Cermakova Z, Miklik R, Malik P, Pes O, Lipkova J, Tomandlova M, Kala P. Prognostic utility of biomarkers in predicting of one-year outcomes in patients with aortic stenosis treated with transcatheter or surgical aortic valve implantation. PLoS One 2012; 7:e48851. [PMID: 23272045 PMCID: PMC3522688 DOI: 10.1371/journal.pone.0048851] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Accepted: 10/01/2012] [Indexed: 11/26/2022] Open
Abstract
Objectives The aim of the work was to find biomarkers identifying patients at high risk of adverse clinical outcomes after TAVI and SAVR in addition to currently used predictive model (EuroSCORE). Background There is limited data about the role of biomarkers in predicting prognosis, especially when TAVI is available. Methods The multi-biomarker sub-study included 42 consecutive high-risk patients (average age 82.0 years; logistic EuroSCORE 21.0%) allocated to TAVI transfemoral and transapical using the Edwards-Sapien valve (n = 29), or SAVR with the Edwards Perimount bioprosthesis (n = 13). Standardized endpoints were prospectively followed during the 12-month follow-up. Results The clinical outcomes after both TAVI and SAVR were comparable. Malondialdehyde served as the best predictor of a combined endpoint at 1 year with AUC (ROC analysis) = 0.872 for TAVI group, resp. 0.765 (p<0.05) for both TAVI and SAVR groups. Increased levels of MDA, matrix metalloproteinase 2, tissue inhibitor of metalloproteinase (TIMP1), ferritin-reducing ability of plasma, homocysteine, cysteine and 8-hydroxy-2-deoxyguanosine were all predictors of the occurrence of combined safety endpoints at 30 days (AUC 0.750–0.948; p<0.05 for all). The addition of MDA to a currently used clinical model (EuroSCORE) significantly improved prediction of a combined safety endpoint at 30 days and a combined endpoint (0–365 days) by the net reclassification improvement (NRI) and the integrated discrimination improvement (IDI) (p<0.05). Cystatin C, glutathione, cysteinylglycine, asymmetric dimethylarginine, nitrite/nitrate and MMP9 did not prove to be significant. Total of 14.3% died during 1-year follow-up. Conclusion We identified malondialdehyde, a marker of oxidative stress, as the most promising predictor of adverse outcomes during the 30-day and 1-year follow-up in high-risk patients with symptomatic, severe aortic stenosis treated with TAVI. The development of a clinical “TAVIscore” would be highly appreciated. Such dedicated scoring system would enable further testing of adjunctive value of various biomarkers.
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Affiliation(s)
- Jiri Parenica
- University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
- International Clinical Research Center–Department of Cardiovascular Disease, University Hospital St. Anne's, Brno, Czech Republic
| | - Petr Nemec
- International Clinical Research Center–Department of Cardiovascular Disease, University Hospital St. Anne's, Brno, Czech Republic
- Center of Cardiovascular Surgery and Transplantations, Brno, Czech Republic
| | - Josef Tomandl
- Institute of Biochemistry, Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Jiri Ondrasek
- Center of Cardiovascular Surgery and Transplantations, Brno, Czech Republic
| | | | - Martin Tretina
- Center of Cardiovascular Surgery and Transplantations, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martin Poloczek
- University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Petr Pokorny
- Center of Cardiovascular Surgery and Transplantations, Brno, Czech Republic
| | - Jindrich Spinar
- University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
- International Clinical Research Center–Department of Cardiovascular Disease, University Hospital St. Anne's, Brno, Czech Republic
| | - Zdenka Cermakova
- Biochemistry Department, Faculty Hospital Brno, Brno, Czech Republic
- Institute of Laboratory Methods, Masaryk University, Brno, Czech Republic
| | | | - Petr Malik
- Center of Cardiovascular Surgery and Transplantations, Brno, Czech Republic
| | - Ondrej Pes
- Institute of Biochemistry, Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Jolana Lipkova
- Institute of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marie Tomandlova
- Institute of Biochemistry, Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Petr Kala
- University Hospital Brno, Brno, Czech Republic
- Medical Faculty, Masaryk University, Brno, Czech Republic
- * E-mail:
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Spinarova L, Spinar J, Vitovec J, Linhart A, Widimsky P, Fedorco M, Malek F, Cihalik C, Miklik R, Dusek L, Zidova K, Jarkovsky J, Littnerova S, Parenica J. Gender differences in total cholesterol levels in patients with acute heart failure and its importance for short and long time prognosis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2012; 156:21-8. [PMID: 22580857 DOI: 10.5507/bp.2012.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIM The purpose of this study was to evaluate whether there are gender differences in total cholesterol levels in patients with acute heart failure and if there is an association of this parameter with short and long time mortality. METHODS The AHEAD MAIN registry is a database conducted in 7 university hospitals, all with 24 h cath lab service, in 4 cities in the Czech Republic. The database included 4 153 patients hospitalised for acute heart failure in the period 2006-2009. 2 384 patients had a complete record of their total cholesterol levels. 946 females and 1437 males were included in this analysis. According to the admission total cholesterol levels, patients were divided into 5 groups: < 4.50 mmol/l (group A), 4.50-4.99 mmol/l (group B), 5.0-5.49 mmol/l (group C), 5.50-5.99 mmol/l (group D) and > 6.0 mmol/l (group E). The median total cholesterol levels were 4.24 in males and 4.60 in females (P<0.001). There were differences in the distribution of total cholesterol levels between men and women: group A 57.6 vs 45.0%, group B 13.8 vs 16.3%, group C 9.8 vs 12.5%, group D 7.7 vs 11.4%, group E 11.1 vs 14.8% respectively (all P<0.001). The median age of men was 68.7 vs 77.3 years in women (P<0.001). In all total cholesterol categories women were older than men: group A 77.7 vs 69.5 years, group B 78.6 vs 69.1 years, group C 77.3 vs 68.8 years, group D 76.8 vs 64.2 years, group E 75.6 vs 64.4 years (all P<0.001). For the calculation of long term mortality, the cohort was divided into three groups: total cholesterol levels below 4.50 mmol/l, 4.50-5.49 mmol/l and above 5.50 mmol/l. The log rank test was used for the analysis. RESULTS There were no differences in hospital mortality between male and female in general (9.2 vs 10.8%, P<0.202), or in total cholesterol levels in subgroups. Total cholesterol levels were associated with in-hospital mortality (P<0.002). In the long-term follow up (78 months) patients with total cholesterol levels below 4.5 mmol/l had the worst prognosis (P<0.001). An independent influence of total cholesterol level on mortality and survival was confirmed in the multivariate model as well. CONCLUSIONS Women with acute heart failure had higher total cholesterol levels than men in all ages. There was a higher percentage of women with total cholesterol levels above 6 mmol/l and lower percentage in the group below 4.5 mmol/l than in men. In all, total cholesterol categories women were older than men. Total cholesterol levels are important for in- hospital mortality and long term survival of patients admitted for acute heart failure.
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Affiliation(s)
- Lenka Spinarova
- Internal Cardioangiology Department, University Hospital St. Ann and Faculty of Medicine, Masaryk University Brno, Czech Republic.
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Goldbergova MP, Parenica J, Jarkovsky J, Kala P, Poloczek M, Manousek J, Kluz K, Kubkova L, Littnerova S, Tesak M, Toman O, Pavek N, Cermakova Z, Tomandl J, Vasku A, Spinar J. The association between levels of tissue inhibitor of metalloproteinase-1 with acute heart failure and left ventricular dysfunction in patients with ST elevation myocardial infarction treated by primary percutaneous coronary intervention. Genet Test Mol Biomarkers 2012; 16:1172-8. [PMID: 22971139 DOI: 10.1089/gtmb.2012.0120] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Tissue inhibitors of metalloproteinase (TIMPs) bind to active matrix metalloproteinase (MMPs), and thereby inhibit their proteolytic activity. We investigated the role of polymorphisms in the gene for TIMP-1 and serum levels of TIMP-1 in association with postmyocardial infarction (MI), left ventricular (LV) dysfunction, and symptoms of acute heart failure (AHF) in patients treated with primary percutaneous coronary intervention. METHODS In total, 556 patients with STEMI were evaluated. Levels of TIMP-1 were measured at admission and 24 h after MI onset. The TIMP-1 exon 5 SNP rs4898 (F124F with T>C) located at X chromosome was assayed. RESULTS TIMP-1 levels were higher for men with AHF as well as for men with LV dysfunction (ejection fraction [EF]<40%). According to multivariate analysis, the TIMP-1 level was a factor with an independent negative relationship to EF and AHF in men. An independent relationship between exon 5 TIMP-1 gene polymorphism and EF, AHF or TIMP-1 level was not documented. CONCLUSION These results provide evidence that a higher level of circulating TIMP-1 is independently associated with worse EF and AHF.
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Kala P, Tretina M, Poloczek M, Ondrasek J, Malik P, Pokorny P, Parenica J, Spinar J, Jarkovsky J, Littnerova S, Nemec P. Quality of life after transcatheter aortic valve implantation and surgical replacement in high-risk elderly patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2012; 157:75-80. [PMID: 23073533 DOI: 10.5507/bp.2012.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 06/11/2012] [Indexed: 11/23/2022] Open
Abstract
AIM The aim of this study was to compare the quality of life after transcatheter aortic valve implantation (TAVI) and surgical replacement (SAVR) at one year. METHODS The study included 45 consecutive high-risk patients (average age 82.0 years; logistic Euroscore 22.3%) with symptomatic severe aortic stenosis allocated to TAVI transfemoral, TAVI transapical using the Edwards-Sapien valve or SAVR with the Edwards Perimount bioprosthesis (n=15 in each). The pre-operative characteristics were similar except for more myocardial infarctions in TAVI. The quality of life was assessed using the standardized EQ-5D questionnaire at baseline and on days 30, 90 and 360. The protocol was approved by the local ethics committee and an informed consent was signed. A total of 7 patients (15.5%) died during follow-up. RESULTS At baseline no significant differences in any of the quality-of-life parameters were found except for usual activities described as "best" (46.7% in SAVR vs. 10.0% in TAVI; P=0.002). At 30 and 90 days surviving patients were similar and at 360 days only the anxiety/depression score was "best" in 83.3% SAVR vs. 59.1% (P=0.046). Functional status improved in all patients (NYHA class I-II in 13.3% at baseline vs. 78.9% at 360-days) and the general health median significantly improved in TAVI patients (from 50 to 67; P=0.001) with a positive trend in SAVR patients (P=0.060). CONCLUSIONS At one year, the general quality of life of high-risk patients had significantly improved after transcatheter aortic valve implantation with a positive trend in surgically treated patients.
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Affiliation(s)
- Petr Kala
- Department of Internal Cardiology Medicine LF MU and FN Brno, Czech Republic
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Parenica J, Malaska J, Jarkovsky J, Lipkova J, Dastych M, Helanova K, Litzman J, Tomandl J, Littnerova S, Sevcikova J, Gal R, Sevcik P, Spinar J, Goldbergova MP. Soluble ST2 levels in patients with cardiogenic and septic shock are not predictors of mortality. Exp Clin Cardiol 2012; 17:205-209. [PMID: 23592937 PMCID: PMC3627276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Soluble ST2 (sST2) is an interleukin-33 receptor. sST2 was found to be an independent prognostic factor in patients with myocardial infarction, sepsis and heart failure. OBJECTIVES To assess sST2 levels in patients with cardiogenic shock (CS) and septic shock (SS), and to evaluate the prognostic value of sST2 for short-term mortality. METHODS The present prospective observational study evaluated 32 patients with CS, 17 patients with SS and 61 patients with ST segment elevation myocardial infarction (STEMI )(control group). Samples of serum were collected eight times and the follow-up time was three months. RESULTS sST2 levels were elevated from admission in SS patients relative to patients with CS and STEMI, who exhibited peak sST2 levels 24 h after admission. On admission, CS patients had a median (5th percentile; 95th percentile) sST2 level of 62.5 pg/mL (8.3 pg/mL; 315.8 pg/mL) and SS patients had a median sST2 level of 216.4 pg/mL (46.8 pg/mL; 364.4 pg/mL). ROC analysis found sST2 to be a biomarker that could distinguish between CS and SS at admission (area under the curve [AUC] 0.813; P<0.01) with a cut-off value of 210.4 pg/mL. Patients with STEMI had significantly lower sST2 levels at admission (20.3 pg/mL (4.2 pg/mL; 339.8 pg/mL) compared with CS patients. The AUC of the ROC analysis was 0.671 (P=0.007) for the detection of CS in patients with STEMI. Only a weak correlation was observed between sST2 and B-type natriuretic peptide (r=0.376, P=0.05) and sST2 and N-terminal pro-B-type natriuretic peptide (r=0.496, P=0.019). No statistically significant differences were observed in sST2 levels in patients with CS and SS relative to three-month mortality. CONCLUSION Levels of sST2 at admission are significantly higher in patients with SS compared with CS. sST2 could be a diagnostic marker to distinguish SS and CS as well as CS and STEMI at the time of admission. Levels of sST2 are related to levels of natriuretic peptides in CS but not in SS. sST2 levels are not a suitable prognostic marker for patients with CS and SS.
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Affiliation(s)
- Jiri Parenica
- Department of Internal Cardiology Medicine, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Cente, Department of Cardiovascular Disease, University Hospital St Anne’s, Brno, Czech Republic
| | - Jan Malaska
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Brno, Brno, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Faculty of Medicine, Brno, Czech Republic
| | - Jolana Lipkova
- Institute of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Milan Dastych
- Department of Biochemistry, University Hospital Brno, Brno, Czech Republic
- Department of Laboratory Methods, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Katerina Helanova
- Department of Internal Cardiology Medicine, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Litzman
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Clinical Immunology and Allergology, St Anne’s University Hospital, Brno, Czech Republic
| | - Josef Tomandl
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Simona Littnerova
- Institute of Biostatistics and Analyses, Faculty of Medicine, Brno, Czech Republic
| | - Jana Sevcikova
- Institute of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Roman Gal
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Brno, Brno, Czech Republic
| | - Pavel Sevcik
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Brno, Brno, Czech Republic
| | - Jindrich Spinar
- Department of Internal Cardiology Medicine, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- International Clinical Research Cente, Department of Cardiovascular Disease, University Hospital St Anne’s, Brno, Czech Republic
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Mikulíkova I, Modra H, Blahova J, Marsalek P, Groch L, Siroka Z, Kruzikova K, Jarkovsky J, Littnerova S, Svobodova Z. The effects of Click 500 SC (terbuthylazine) on common carp Cyprinus carpio under (sub)chronic conditions. Neuro Endocrinol Lett 2011; 32 Suppl 1:15-24. [PMID: 22167222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 08/25/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Effects of the herbicide formulation Click 500 SC (terbuthylazine 500 g/l) on common carp Cyprinus carpio were assessed through biometric, biochemical, haematological and antioxidant indices, induction of xenobiotic metabolizing enzymes and histological examination of selected tissues. DESIGN The fish were exposed to the formulation with terbuthylazine concentrations of 380 ng/l (environmental concentration); 60 µg/l and 550 µg/l for up to 91 days. Haematological indices were assessed using unified methods of haematological examination in fish. Biochemical indices in plasma were measured by biochemical analyzer, ferric reducing ability of plasma (FRAP) and ceruloplasmin activity were determined spectrophotometrically. Concentration of total cytochrome P450, glutathione-S-transferase activity and glutathione content were assessed spectrophotometrically in liver. Activity of liver ethoxyresorufin-O-deethylase (EROD) activity was measured spectrofluorimetrically. Histopathological examination of liver, skin, gills, spleen, cranial and caudal kidney was performed by light microscopy. RESULTS An increase (p<0.05) was observed in hepatosomatic index and condition factor in fish from the environmental concentration. A decrease (p<0.05) in haemoglobin and mean corpuscular haemoglobin concentration (MCHC) was found in fish treated with terbuthylazine of 550 µg/l. There was a decline in mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) (p<0.05) in terbuthylazine of 60 µg/l and 550 µg/l. Triglycerides (TAG) (p<0.01) were elevated in all pesticide-treated groups. Alanine aminotransferase (ALT) (p<0.01) and phosphorus (p<0.05) decreased in fish exposed to terbuthylazine of 60 µg/l and 550 µg/l, while albumin (p<0.01) rised in the same groups. An elevation in natrium (p<0.05) in terbuthylazine of 550 µg/l and a rise in protein (p<0.01) in the concentrations of 380 ng/l and 550 µg/l were observed. Correlations between several indices were significant. Ceruloplasmin activity and FRAP were augmented (p<0.01) in the highest concentration tested. Examined xenobiotic detoxification systems were not significantly affected by the exposure. Non-specific histopathological changes were found in the gills and skin of the test fish. CONCLUSION The fish treated with terbuthylazine developed a disorder in several haematological and plasma biochemical indices. The levels of markers of oxidative stress increased in response to the exposure. Examined systems involved in detoxification of xenobiotics did not reflect long-term contact with the herbicide. Detected histological lesions were non-specific. The environmental concentration of terbuthylazin affected biometric indices of the test fish.
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Affiliation(s)
- Ivana Mikulíkova
- Faculty of Veterinary Hygiene and Ecology, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic.
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