다중혈관 관상동맥 환자에서 y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

2007 Guidelines for the Management of Arterial Hypertension : The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC).

So far in this course we have dealt entirely with the evolution of characters that are controlled by simple Mendelian inheritance at a single locus. There are notes on the course website about gametic disequilibrium and how allele frequencies change at two loci simultaneously, but we didn’t discuss them. In every example we’ve considered we’ve imagined that we could understand something about evolution by examining the evolution of a single gene. That’s the domain of classical population genetics. For the next few weeks we’re going to be exploring a field that’s actually older than classical population genetics, although the approach we’ll be taking to it involves the use of population genetic machinery. If you know a little about the history of evolutionary biology, you may know that after the rediscovery of Mendel’s work in 1900 there was a heated debate between the “biometricians” (e.g., Galton and Pearson) and the “Mendelians” (e.g., de Vries, Correns, Bateson, and Morgan). Biometricians asserted that the really important variation in evolution didn’t follow Mendelian rules. Height, weight, skin color, and similar traits seemed to

Human biochemical genetics

ACE
: angiotensin-converting enzyme
ACS
: acute coronary syndrome
ADP
: adenosine diphosphate
AF
: atrial fibrillation
AMI
: acute myocardial infarction
AV
: atrioventricular
AIDA-4
: Abciximab Intracoronary vs. intravenously Drug Application
APACHE II
: Acute Physiology Aand Chronic

/pdf/esc-guidelines-for-the-management-of-acute-myocardial-vy5rt9aiqe.pdf

ESC Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting With ST-Segment Elevation

Iatrogenic aortic dissection as a complication of percutaneous coronary interventions


 
 
 Type of funding sources: Public Institution(s). Main funding source(s): Charles University Research program “Cooperatio - Cardiovascular Science”.
 
 
 
 Fabry disease (FD) is a multisystemic lysosomal storage disorder caused by a defect in the gene coding the alpha-galactosidase A enzyme. Cardiac involvement typically manifests as a phenocopy of hypertrophic cardiomyopathy. Three-dimensional echocardiography can analyze myocardial deformation of the left ventricle (LV) in both circumferential and longitudinal dimensions.
 
 
 
 We assessed 3D echocardiographic strain of the LV in FD patients in relation to heart failure severity, the presence of cardiovascular magnetic resonance (CMR) scar and long-term prognosis.
 
 
 
 3D echocardiography was feasible in 75/99 FD patients. Baseline natriuretic peptides and CMR late gadolinium enhancement were assessed together with long term outcome (death, heart failure decompensation or cardiovascular hospitalization) over a median follow-up of 3.1 years.
 
 
 
 The average age was 47 ± 14 years, 44% of patients were male and 51% expressed hypertrophy or concentric remodeling of the LV. Average LV ejection fraction (EF) was 65 ± 6%. A stronger correlation was observed for NTproBNP levels with 3D global longitudinal strain (GLS) (r = 0.49, p < 0.0001) than with 3D global circumferential strain (GCS) (r = 0.38, p < 0.001). LV EF by 3D weakly correlated with NTproBNP levels (r = 0.25, p = 0.036). Individuals with posterolateral scar on CMR had significantly lower local 3D circumferential strain at corresponding region (p = 0.008). 3D GLS was associated with long-term outcome (adjusted HR 0.84, CI 0.75, 0.95, p = 0.004) while 3D GCS was not (HR 0.94, CI 0.85 – 1.10, p = 0.284). 3D LV EF was not associated with long-term outcome.
 
 
 
 3D GLS is strongly associated with both heart failure severity measured as natriuretic peptides levels and long-term prognosis. Only borderline association of 3D GCS with HF severity and no association with prognosis was observed. Decreased local 3D CS reflects typical posterolateral scarring in FD. Where feasible, 3D-strain echocardiography can be used for comprehensive mechanical assessment of the LV in FD patients.


/pdf/three-dimensional-left-ventricular-strain-analysis-in-fabry-1229umnt.pdf

Three-dimensional left ventricular strain analysis in Fabry disease: correlation with heart failure severity, myocardial scar and impact on long-term prognosis

P005: Head-to-head trial of pegunigalsidase alfa vs agalsidase beta in Fabry disease: Phase 3 randomized, double-blind, BALANCE Study 2-year results

Kompletni atrioventrikularni (AV) blokada představuje vzacnou, avsak život ohrožujici komplikaci tyreotoxikozy. V literatuře bylo dosud popsano pouze několik připadů s nejistou kauzalni souvislosti s hypertyroidnim stavem. Vzhledem k nedostatku udajů nepanuje absolutni shoda ohledně reverzibility teto abnormality AV převodu, a tedy i nutnosti implantace trvaleho kardiostimulatoru. V nasi kazuistice popisujeme připad 35lete pacientky, u ktere se nově diagnostikovana Gravesova-Basedowova tyreotoxikoza poprve manifestovala synkopou při kompletni AV blokadě. V uvodu hospitalizace doslo ke spontanni obnově AV převodu v poměru 1 : 1, což vedlo k výrazne sinusove tachykardii s frekvenci 150/min, ktera byla symptomaticka bolestmi na hrudi, prekolapsovým stavem a vedla k rozvoji srdecniho selhani v důsledku hyperkineticke cirkulace. Dalsi komplikaci byla epizoda asystolie při recidivě uplne AV blokady bez nahradniho rytmu s nutnosti dvouminutove kardiopulmonalni resuscitace a emergentni docasne transvenozni kardiostimulace. Při lecbě tyreostatiky a kortikosteroidy se po 48 hodinach stabilizoval srdecni rytmus se sklonem k sinusove tachykardii. Dalsi průběh byl již nekomplikovaný, vcetně dobre tolerance lecby beta-blokatorem. Komplexni vysetřeni (vcetně magneticke rezonance srdce) neprokazalo žadnou jinou přicinu vysvětlujici kompletni AV blokadu. Zvažovanou implantaci trvaleho kardiostimulatoru pacientka odmitla. V nasledujicich třech měsicich sledovani již nebyla recidiva AV blokady zaznamenana. © 2019, CKS.

Aleš Linhart

Papers

Iatrogenic aortic dissection as a complication of percutaneous coronary interventions

Three-dimensional left ventricular strain analysis in Fabry disease: correlation with heart failure severity, myocardial scar and impact on long-term prognosis

P005: Head-to-head trial of pegunigalsidase alfa vs agalsidase beta in Fabry disease: Phase 3 randomized, double-blind, BALANCE Study 2-year results

Third degree atrioventricular block as a rare complication of Graves' thyrotoxicosis

Sport je pro srdce statisticky zdravý, jenže statistika je zrádná věc…