Hlavní téma – novinky v kardiologii

MUDr. Michael Jenšovský

Vnitr Lek 2026, 72(2):71  

Novel therapies for hypertrophic cardiomyopathy

Michael Jenšovský, Veronika Puchnerová, Jiří Bonaventura, Petr Ošťádal

Vnitr Lek 2026, 72(2):76-80 | DOI: 10.36290/vnl.2026.017  

Hypertrophic cardiomyopathy (HCM) is a genetic disease that requires complex diagnostics and evolving therapeutic options. We present advances in pharmacotherapy of HCM in the year 2025. We focus on the results of trials involving myosin inhibitors and the implications of these studies on daily practice. Additionally, we explore experimental therapies with novel mechanisms of action in different stages of development. Lastly, we describe the current structure of expert centers that care for HCM patients in the Czech Republic.

Advances in the treatment of acute coronary syndromes - from standardized algorithms to individualized therapy

Karolína Bartošková, Zuzana Moťovská

Vnitr Lek 2026, 72(2):81-84 | DOI: 10.36290/vnl.2026.018  

Recent years have brought a shift in the management of acute coronary syndromes (ACS) from uniform treatment algorithms towards an individualized, risk-based approach. This strategy integrates ischaemic and bleeding risk assessment, clinical course and patient comorbidities. The most relevant changes concern antithrombotic therapy, including duration and composition of dual antiplatelet therapy, early P2Y12 inhibitor monotherapy and de-escalation strategies. Further developments involve the selective use of mechanical circulatory support in cardiogenic shock and an expanding role of adjunctive pharmacotherapy after myocardial infarction. This review...

Recent advances in the pharmacotherapy of pulmonary arterial hypertension

Lucie Miksová, Pavel Jansa

Vnitr Lek 2026, 72(2):86-91 | DOI: 10.36290/vnl.2026.019  

Pulmonary arterial hypertension (PAH) is a rare, progressive, and life-threatening disease characterized by pathological remodeling of the pulmonary vasculature, ultimately leading to right ventricular failure. Despite substantial advances in diagnostic strategies and therapeutic options over recent decades, the prognosis of patients with PAH remains unfavorable, and a sustained low-risk profile cannot be achieved in a considerable proportion of patients even when treated according to current guideline recommendations. Current PAH-specific pharmacotherapy primarily targets the endothelin, prostacyclin, and nitric oxide-cGMP signaling pathways, with...

What's new in the ESC guidelines for management of valvular heart disease?

Hana Línková

Vnitr Lek 2026, 72(2):92-96 | DOI: 10.36290/vnl.2026.020  

Valvular heart disease is a major cause of morbidity and mortality, especially in the elderly population. In 2025, updated recommendations from the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) were published, reflecting the rapid development of transcatheter treatment methods, advances in imaging techniques, and new results from clinical studies. Compared to the recommendations issued in 2021, they mark a further step forward and change clinical practice. This mainly involves shifting interventions to earlier stages of disease development and expanding the role of transcatheter treatment of valve...

Hypertension in women and men

Barbora Nussbaumerová

Vnitr Lek 2026, 72(2):99-103 | DOI: 10.36290/vnl.2026.021  

This paper summarizes current knowledge on the epidemiology, diagnosis, treatment, and the potential development of target organ damage in hypertension in women and men, with an emphasis on sex-related differences, based on current clinical guidelines. Women have a lower prevalence of hypertension at a younger age; however, after menopause, prevalence may equal or even exceed that in men. Women with high-normal blood pressure may be more likely to develop hypertension than men. Compared with men, women may be more susceptible to hypertension-related target organ damage, and hypertension in women may be associated with a higher risk of ischemic heart...

New generation anti-obesity drugs and bone health in postmenopausal women

Jana Tomasová Studýnková

Vnitr Lek 2026, 72(2):104-112 | DOI: 10.36290/vnl.2026.022  

Obesity represents a major global medical and socioeconomic challenge. The prevalence of overweight and obesity has increased markedly over the past three decades and currently affects nearly one third of the world's population. Up to 70 % of women experience weight gain during the menopausal transition. Glucagon-like peptide-1 receptor agonists (GLP-1RA) represent an effective pharmacological treatment for overweight and obesity and have become an important therapeutic option across various populations, including peri- and postmenopausal women. Available data suggest that some of these agents may have a beneficial effect on bone mineral density and...

Spironolactone in the treatment of heart failure and resitant arterial hypertension

Filip Málek

Vnitr Lek 2026, 72(2):113-116 | DOI: 10.36290/vnl.2026.023  

Chronic heart failure is clinical syndrome charatcterised by increasing prevalence and unfavorable prognosis. Resistent arterial hypertension increases the risk of cardiovascular events and the risk of death from cardiovascular causes. Both heart failure and resistant arterial hypertension are associated with secondary hyperaldosternism. Spironolactone blocks the adverse effects of aldosterone on the level of its receptors Its efficacy in the indications of heart failure and resistant arterial hypertension is supported by scientific findings, it is also supported by the guidelines from professional societies.Spironolactone reduces mortality and morbidity...

Reassessing the SIBO-Hypertension Link in Symptomatic Patients

Pavol Fülöp, Lívia Szczygieľová, Štefan Tóth, Tibor Porubän, Mariana Dvorožňáková, Natália Vaňová

Vnitr Lek 2026, 72(2):E1-E6 | DOI: 10.36290/vnl.2026.027  

Background: Recent evidence suggests small intestinal bacterial overgrowth (SIBO) may serve as a diagnostic marker for hypertension through gut-cardiovascular axis mechanisms. However, this relationship has not been evaluated in symptomatic gastrointestinal patients. We aimed to assess the association between SIBO and arterial hypertension in patients undergoing clinical evaluation for gastrointestinal symptoms. Methods: Retrospective cross-sectional analysis of 331 consecutive symptomatic patients (263 controls, 68 with hypertension) who underwent hydrogen breath testing. SIBO was diagnosed using North American Consensus criteria (H₂ rise ≥20...

Valve-in-valve transcatheter implantation of a valve replacement in the mitral position using the LAMPOON technique

Beáta Šoltésová, Zuzana Hlubocká, Tomáš Bouček, Tomáš Kovárník, David Zemánek

Vnitr Lek 2026, 72(2):E7-E11 | DOI: 10.36290/vnl.2026.028  

Over the last ten years, there has been a significant progression in the possibilities of trascatheter intervention on the mitral valve, both on the native valve and on bioprostheses. Although surgical treatment of mitral defects currently prevails, transcatheter mitral valve replacement is mainly used in patients with a high surgical risk or in patients with valve replacement with a bioprosthesis in whom reoperation is no longer possible. Transcatheter implantation of a bioprosthesis into the mitral position has its specifics and complications. One of the possible complications is the formation of a significant obstruction in the outflow tract of...

Hyperuricemia: Indications for treatment vs. non-treatment according to current guidelines

Zdeněk Monhart

Vnitr Lek 2026, 72(2):118-119 | DOI: 10.36290/vnl.2026.024  

Pharmacological treatment of hyperuricemia is indicated in patients with clear clinical manifestations such as gout or nephrolithiasis. Current guidelines do not support pharmacotherapy for asymptomatic hyperuricemia, even in the presence of chronic kidney disease (CKD) or cardiovascular disease.

RECENZE KNIHY Etika a komunikace v medicíně

Prof. MUDr. Jan Škrha, DrSc.

Vnitr Lek 2026, 72(2):133  

Fixed combination of rosuvastatin and perindopril - the next step in cardiovascular disease prevention

Jiří Vítovec

Vnitr Lek 2026, 72(2):120-122 | DOI: 10.36290/vnl.2026.025  

The combination of a statin and an ACE inhibitor represents a modern therapeutic approach to the simultaneous management of hypercholesterolemia and arterial hypertension - the two main risk factors for cardiovascular disease (CVD). The fixed-dose combination of rosuvastatin and perindopril provides comprehensive prevention of CVD in patients at high or very high risk. This combination offers synergistic effects on blood pressure and lipid levels, and its simplified regimen improves patient adherence. This article summarizes the pharmacological properties of both agents, the rationale and benefits of their fixed combination, clinical indications, and...

Zmírnění příznaků i projevů chronického žilního onemocnění všech stadií při užívání mikronizované purifikované flavonoidní frakce - metaanalýza 56 studií

MUDr. Zuzana Zafarová

Vnitr Lek 2026, 72(2):127-132  

AI audio processing transforms healthcare

Jan Rychtar

Vnitr Lek 2026, 72(2):123-126 | DOI: 10.36290/vnl.2026.026  

Artificial intelligence is revolutionizing audio processing in healthcare. The article presents key applications: ambient AI scribe systems automatically generate medical documentation from doctor-patient conversations, saving hours of work and reducing burnout. Intelligent voicebots streamline phone communication in clinics. In diagnostics, AI analyzes cough sounds to detect respiratory diseases, while digital stethoscopes recognize heart murmurs with accuracy exceeding that of typical physicians. Voice analysis reveals signs of Parkinson's disease, Alzheimer's dementia, and depression. Smartphone applications enable sleep apnea screening from nighttime...