Entity

Time filter

Source Type

Brno, Czech Republic

Vaclavik J.,Palacky University | Spinar J.,University Hospital Brno | Vindis D.,Palacky University | Vitovec J.,University Hospital St Annes | And 11 more authors.
Internal and Emergency Medicine | Year: 2014

Initial risk stratification in patients with acute heart failure (AHF) is poorly validated. Previous studies tended to evaluate the prognostic significance of only one or two selected ECG parameters. The aim of this study was to evaluate the impact of multiple ECG parameters on mortality in AHF. The Acute Heart Failure Database (AHEAD) registry collected data from 4,153 patients admitted for AHF to seven hospitals with Catheter Laboratory facilities. Clinical variables, heart rate, duration of QRS, QT and QTC intervals, type of rhythm and ST-T segment changes on admission were collected in a web-based database. 12.7 % patients died during hospitalisation, the remainder were discharged and followed for a median of 16.2 months. The most important parameters were a prolonged QRS and a junctional rhythm, which independently predict both in-hospital mortality [QRS > 100 ms, odds ratio (OR) 1.329, 95 % CI 1.052-1.680; junctional rhythm, OR 3.715, 95 % CI 1.748-7.896] and long-term mortality (QRS > 120 ms, OR 1.428, 95 % CI 1.160-1.757; junctional rhythm, OR 2.629, 95 % CI 1.538-4.496). Increased hospitalisation mortality is predicted by ST segment elevation (OR 1.771, 95 % CI 1.383-2.269) and prolonged QTC interval >475 ms (OR 1.483, 95 % CI 1.016-2.164). Presence of atrial fibrillation and bundle branch block is associated with increased unadjusted long-term mortality, but mostly reflects more advanced heart disease, and their predictive significance is attenuated in the multivariate analysis. ECG in patients admitted for acute heart failure carries significant short- and long-term prognostic information, and should be carefully evaluated. © 2012 SIMI. Source


Helanova K.,Masaryk University | Spinar J.,Masaryk University | Spinar J.,University Hospital St Annes | Parenica J.,Masaryk University | Parenica J.,University Hospital St Annes
Kidney and Blood Pressure Research | Year: 2014

NGAL (neutrophil gelatinase-associated lipocalin) is an acute phase protein, participating in antibacterial immunity. NGAL forms a complex with metalloproteinase 9 (MMP-9), thereby increasing its activity and preventing its degradation. NGAL is freely filtered through the glomerular membrane and reabsorbed by endocytosis in the proximal tubule. NGAL detected in urine is produced mainly in the distal nephron. Elevated serum and urine NGAL allows diagnosis of acute kidney injury approximately 24 hours earlier than plasma creatinine concentration. Increased levels of NGAL were detected in patients with acute myocardial infarction, heart failure or stroke and were demonstrated to be strong predictors of adverse prognosis. © 2014 S. Karger AG, Basel. Source


Lipkova J.,Masaryk University | Splichal Z.,Masaryk University | Bienertova-Vasku J.A.,Masaryk University | Jurajda M.,Masaryk University | And 5 more authors.
Chronobiology International | Year: 2014

It is well established that the incidence and infarct size in acute myocardial infarction (AMI) is subject to circadian variations. At the molecular level, circadian clocks in distinct cells, including cardiomyocytes, generate 24-h cycles of biochemical processes. Possible imbalance or impairment in the cell clock mechanism may alter the cardiac metabolism and function and increase the susceptibility of cardiovascular diseases. One of the key components of the human clock system PERIOD3 (PER3) has been recently demonstrated to affect circadian expression of various genes in different tissues, including the heart. The variable number tandem repeat (VNTR) polymorphism (rs57875989) in gene Period3 (Per3) is related to multiple phenotypic parameters, including diurnal preference, sleep homeostasis, infection and cancer. The aim of our study was to investigate the effect of this polymorphism in AMI with ST elevation (STEMI). The study subjects (314 patients of Caucasian origin with STEMI, and 332 healthy controls) were genotyped for Per3 VNTR polymorphism using an allele-specific polymerase chain reaction. A gender difference in circadian rhythmicity of pain onset was observed with significant circadian pattern in men. Furthermore, the Per35/5variant carriers were associated with higher levels of interleukin-6, B-type natriuretic peptide and lower vitamin A levels. By using cosinor analysis we observed different circadian distribution patterns of AMI onset at the level of genotype and allelic frequencies. Genotypes with at least one 4-repeat allele (Per34/5and Per34/4) (N=264) showed remarkable circadian activity in comparison with Per35/5(N=50), especially in men. No significant differences in genotype and/or allele frequencies of Per3 VNTR polymorphism were observed when comparing STEMI cases and controls. Our results indicate that the Per3 VNTR may contribute to modulation of cardiac functions and interindividual differences in development and progression of myocardial infarction. © Informa Healthcare USA, Inc. Source


Krupicka J.,Charles University | Andruskova A.,Hospital Znojmo | Hegarova M.,Institute for Clinical and Experimental Medicine | Lazarova M.,University Hospital Olomouc | And 5 more authors.
Cor et Vasa | Year: 2015

Introduction The ESC Heart Failure Long-Term Registry (ESC-HFLTR) is a prospective observational study which takes place in 211 cardiology centres of 21 European and Mediterranean countries, members of the European Society of Cardiology. Aim To compare basic demographic and clinical characteristics of both, the patients hospitalized for acute heart failure and the patients observed in outpatient clinics for chronic heart failure in the Czech Republic with published European-wide data. Methods Altogether 692 consecutive patients were included in the Czech part of ESC-HFLTR (5.6% of the whole registry) from May 2011 to April 2013. These patients were either admitted to hospital or examined in the outpatient clinic for HF during one predefined day of the week. The basic characteristics of 160 hospitalized (25.3%) and 532 ambulatory (74.7%) patients were analysed statistically, compared with each other and finally contrasted with available data from the whole ESC-HFLTR. Results Czech in-hospital patients were generally older than the ambulatory patients with HF (73 vs. 66 years; p < 0.001) and were less frequently men (62.5 vs. 75.7%). They had also significantly higher incidence of comorbidities. On the contrary, the outpatients underwent more often pacemaker implantation and coronary revascularization than hospitalized patients. The dominant HF aetiology was ischaemic in both groups. The HF with preserved ejection fraction was more frequently represented among the hospitalized HF patients. On the other hand, more ambulatory patients had dilated cardiomyopathy as the primary cause of HF. In comparison with the data from the whole ESC-HFLTR Czech HF patients in both groups had significantly higher body weight, systolic blood pressure and higher incidence of comorbidities. In addition, they had more frequently implanted a pacemaker. Conclusion Czech HF patients had worse cardiovascular risk profile as well as higher incidence of comorbidities compared to the patients from the whole ESC-HFLTR. © 2015 The Czech Society of Cardiology. Source


Krupicka J.,Charles University | Andruskova A.,Hospital Znojmo | Hegarova M.,Institute for Clinical and Experimental Medicine | Lazarova M.,University Hospital Olomouc | And 5 more authors.
Cor et Vasa | Year: 2016

Introduction: The ESC Heart Failure Long-Term Registry (ESC-HFLTR) is a prospective observational study which takes place in 211 cardiology centres of 21 European and Mediterranean countries, members of the European Society of Cardiology. Aim: To compare pharmacological and device therapy of both, the patients hospitalized for acute heart failure (HF) and the patients observed in outpatient clinics for chronic HF in the Czech Republic with published European-wide data. Methods: Altogether 692 consecutive patients were included into the Czech part of HFLTR (5.6% of the whole registry) from May 2011 to April 2013. These patients were either admitted to hospital or examined in outpatient clinic for HF during one predefined day of the week. The pharmacological and device therapy of 160 hospitalized (25.3%) and 532 ambulatory (74.7%) patients was analyzed statistically. The treatment of Czech ambulatory patients was finally compared with available data from the whole HFLTR. Results: The Czech in-hospital patients were intravenously treated generally with furosemide (in 89.3%), less frequently with nitrates (in 21.9%) and occasionally with inotropic agents (in 15.0%). In comparison with therapy before the hospital admission the patients at discharge received more frequently diuretics (69.4 vs. 87.5%; p <. 0.001) and mineralocorticoid receptor antagonist (MRA) (32.4 vs. 55.0%; p <. 0.001). The majority of Czech patients with chronic HF were treated according to current European guidelines. All prognostically relevant drugs used in HF were administered more often in the Czech HF population than in the whole HFLTR population (inhibitor of angiotensin converting enzyme or angiotensin receptor blocker in 92.8 vs. 89.2%; p = 0.018, betablocker in 95.1 vs. 88.9%; p <. 0.001, MRA in 67.0 vs. 59.3%; p <. 0.001, respectively). The recommended target doses of these drugs were reached in about 20% of the Czech as well as the European HF patients. In addition, the Czech ambulatory HF patients underwent more often pacemaker implantation (47 vs. 42%; p = 0.028), mainly due to more frequently indicated resynchronization therapy (56 vs. 30.2%; p <. 0.001). Conclusion: Czech ambulatory HF patients are pharmacologically treated in accordance with current European HF guidelines and significantly better than the patients in the whole HFLTR. However, the recommended target doses were reached only in the minority of the patients. © 2016 The Czech Society of Cardiology. Source

Discover hidden collaborations