Hlavní téma – kardiologie

prof. MUDr. Hana Rosolová, DrSc.

Vnitr Lek 2023, 69(2):71  

Preventive cardiology: Quo vadis?

Hana Rosolová

Vnitr Lek 2023, 69(2):76-81 | DOI: 10.36290/vnl.2023.014  

Reflections of preventive cardiology history, it´s development and look to the future are mentioned. The main problems of primary and secondary prevention for atherosclerotic cardiovascular diseases are presented. New ways to the prevention improvement are sketched in the field of physician care, inside the whole society and throught the new technologies.

New perspectives in the treatment of chronic heart failure

Barbora Nussbaumerová

Vnitr Lek 2023, 69(2):82-87 | DOI: 10.36290/vnl.2023.015  

The most recent guidelines on heart failure of the European Society of Cardiology were published in 2021. These guidelines devide patients according to the ejection fraction of the left ventricle into the group with reduced, mildly reduced and preserved ejection fraction. The guidelines follow the recent evidence based medicine and clinical studies in their recommendations. A novel group of drugs aiming to reduce morbidity and mortality and to improve the quality of life in patients with reduced ejection frations are SGLT2 inhibitors - gliflozins. The guidelines of the American Society of Cardiology set the treatment by gliflozins regardless of ejection...

News in diagnostics and treament of cardiomyopathies

Hana Poloczková, Tomáš Honek, Anna Chaloupka, Lukáš Opatřil, Mária Bakošová, Jan Krejčí

Vnitr Lek 2023, 69(2):89-104 | DOI: 10.36290/vnl.2023.016  

Cardiomyopathies are defined as myocardial disorders in which the heart muscle is structurally and functionaly abnormal in the absence of a disease sufficient to cause this abnormality such as coronary artery disease, hypertension, valvular or congenital heart disease. According to the phenotype expresion cardiomyopathies are divided into dilated, hypertrophic, restrictive, arrhytmogenic and unclassified cardiomyopathies (noncompaction and tako-tsubo cardiomyopathy). The same phenotypic expression may include etiologically different forms of the disease, and at the same time phenotypic expression may change in many cardiomyopathies in the course of...

The impact of uncontrolled hypertension on the CNS

Aleš Tomek

Vnitr Lek 2023, 69(2):105-108 | DOI: 10.36290/vnl.2023.017  

The brain is a target of organ damage due to hypertension. In addition to acute damage in the form of hypertensive encephalopathy, ischaemic stroke, and intracerebral haemorrhage, hypertension causes chronic changes in the brain tissue that, over the course of years, will be manifested by impaired brain functions including cognitive deficit. Hypertension is also a risk factor for progression of cognitive disorder to overt dementia. It is commonly accepted that the earlier in life hypertension occurs, the greater the risk of developing dementia in old age. The pathophysiological mechanism underlying this effect of hypertension is microvascular damage...

Pain treatment options for osteoarthritis

Olga Šléglová

Vnitr Lek 2023, 69(2):119-127 | DOI: 10.36290/vnl.2023.019  

Osteoarthritis is one of the most common diseases of the joints and spine and is characterized by degenerative changes starting in the cartilage. Joint changes cause pain, stiffness, swelling, and a loss of normal joint function. Several international recommendations address the choice of treatment methods for osteoarthritis. However, because there is still no effective causal treatment leading to a remission of the disease, this is a complex issue. Even the possibilities of effective but safe treatment of pain, which is the most common problem accompanying osteoarthritis, are very limited. All current international recommendations for the treatment...

Levothyroxine suppressive therapy in differentiated thyroid cancer treatment

Jan Drugda, Jan Čáp, Mikuláš Kosák, Filip Gabalec

Vnitr Lek 2023, 69(2):128-131 | DOI: 10.36290/vnl.2023.020  

Levothyroxine therapy in management of diferentiated thyroid carcinoma (DTC) has been common practice for decades. Levothyroxine is being administered to patiens with DTC after total thyreoidectomy (with or without postopreative radioiodine treatment) not only to restore euthyroidism but to suppress the production of thyroid-stimulating hormone (TSH) as well because TSH is considered as a growth factor for thyroid follicular cells. However there has been a downside to this threatment recently. The main concerns are the known risks related to iatrogenic subclinical or even mild but clinicaly overt iatrogenic hyperthyroidism. Therefore individualized...

Anemia of inflammatory: does eiderr knowledge mean better diagnosis and treatment?

Jaromír Tupý

Vnitr Lek 2023, 69(2):E10-E18 | DOI: 10.36290/vnl.2023.023  

Anemia, which is a manifestation of the deterioration of patients' health and performance, is a common concomitant condition in diseases with signs of inflammation activation. This anemia - anemia of inflammation, is caused by disturbances of iron metabolism that lead to iron retention within macrophages, cytokine mediated inhibition of erythropoietin function and erythroid progenitor cell differentiation, and a reduced erytrocyte half-life. Anemia is usually mild to moderate, normocytic and normochromic. It is characterized by low iron circulation, but normal to increased levels of stored ferritin and the hormone hepcidin. The primary therapeutic...

Dosing of basic pharmacotherapy and its effect on the prognosis of patients hospitalized for heart failure

Tomáš Krynský, Otto Mayer Jr., Jan Bruthans, Simona Bílková, Josef Jirák

Vnitr Lek 2023, 69(2):109-118 | DOI: 10.36290/vnl.2023.018  

Background: We analyzed the prescription and dosage of essential pharmacotherapy in chronic heart failure (HF) at the time of discharge from the hospitalization for cardiac decompensation and how it may have influenced the prognosis of the patients. Methods: We followed 4097 patients [mean age 70.7, 60.2% males] hospitalized for HF between 2010 and 2020. The vital status we ascertained from the population registry, other circumstances from the hospital information system. Results: The prescription of beta-blockers (BB) was 77.5% (or only 60.8% of BB with evidence in HF), 79% of renin-angiotensin system (RAS) blockers, and 45.3% of mineralocorticoid...

Comparison of polypharmacy and pharmacotherapy among seniors in social institutions in 2001 and 2019

Ivan Bartošovič, Ivana Ivánková Bartošovičová, Katarína Zrubáková, Peter Mikus, Róbert Ochaba, Irina Goljerová

Vnitr Lek 2023, 69(2):E05-E09 | DOI: 10.36290/vnl.2023.022  

Introduction: Polypharmacy (polypharmacotherapy) is a serious problem among seniors. The aim of the work was to compare pharmacotherapy and polypharmacy among seniors in social facilities in 2001 and 2019. Methodology: As of December 31, 2001, we collected data on the pharmacotherapy of 151 residents of two retirement homes (average age 75.1 years, 68.9% women). We compared the results with the pharmacotherapy of residents of two facilities for seniors as of October 31, 2019 (237 seniors, average age 80.5 years, 73.4% women). According to the medical records, we determined and compared the regularly used medicines of all residents, the use of medicines...

Severe autoimune thyreotoxicosis complicated by febrile neutropenia as a result of thyreostatic therapy

Marie Jarolímová, Michal Kazmíř

Vnitr Lek 2023, 69(2):E19-E22 | DOI: 10.36290/vnl.2023.024  

Hyperthyreoidism is a clinical manifestation of excessive production of thyroid hormones. In most cases pacient´s condition allows ambulant treatment. Rarely, it can develop into an acute, life- threatening thyrotoxic crisis which has to be treated in the intensive care unit. Main therapy includes antithyroid medication, corticosteroids, beta-blockers and rehydratation, mostly parenteral. If initial treatment fails, plasmapheresis provides effective strategy. Antithyroid medication may come with side effects as rash, digestive issues, joint pain.Agranulocystosis or acute liver lesion which leads to liver failure belong among the most severe ones. In...

Diabetes mellitus urological complication

Miroslava Ryšánková

Vnitr Lek 2023, 69(2):E26-E30 | DOI: 10.36290/vnl.2023.026  

Diabetes mellitus is a disease characterized by chronic hyperglycaemia due to an absolute or relative lack of insulin. The disease mainly affects the nervous system, and the urological complications themselves develop on the basis of these disorders. Urological patients with diabetes present in ambulance with manifestations of common urological diseases, but also suffer from complications of the urinary system or genital organs that are specific for diabetic patient. Usually, these complications go unrecognized for a long time or manifest only non-specifically. But they are often life-threatening for patients. Treatment does not consist only in urological...

Role of eplerenone in the threatment of cardiovascular diseases

Filip Málek

Vnitr Lek 2023, 69(2):E23-E25 | DOI: 10.36290/vnl.2023.025  

Eplerenone is a selective mineralocorticoid receptor antagonist. Its approved for the therapy of patients with chronic heart failure with left ventricular systolic dysfunction and for the patients after myocardial infarction complicated by heart failure and left ventricular dysfunction. It´s also recommended for the therapy of primary hyperaldosteronism and the treatment of drug resistant hypertension.

News in immunology

Jiřina Bartůňková, Markéta Bloomfield, Magdalena Havlišová, Adam Klocperk, Helena Kubešová, Michal Podrazil, Zuzana Střížová, Anna Šedivá

Vnitr Lek 2023, 69(2):133-137 | DOI: 10.36290/vnl.2023.021  

The field of immunology has undergone a very significant development in recent decades, which has been reflected especially in the beginning of this millennium in significant advances in the understanding of the immune system and in the application of this knowledge in practice. The progress and acceleration of research and advances in the field of immunology was further prompt by the unexpected onset of the COVID-19 pandemic in 2020. The intense scientific work has not only led to the development of our understanding of the immune response to viruses, but also to the rapid conversion of this knowledge into practical pandemic management on a global...