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Showing papers by "Renata Cifkova published in 2011"


Journal ArticleDOI
TL;DR: Recommendations for the prevention and management of venous thrombo-embolism in pregnancy and puerperium and the associated risk groups according to risk factors: definition and preventive measures are presented.
Abstract: Table 1. Classes of recommendation Table 2. Levels of evidence Table 3. Estimated fetal and maternal effective doses for various diagnostic and interventional radiology procedures Table 4. Predictors of maternal cardiovascular events and risk score from the CARPREG study Table 5. Predictors of maternal cardiovascular events identified in congential heart diseases in the ZAHARA and Khairy study Table 6. Modified WHO classification of maternal cardiovascular risk: principles Table 7. Modified WHO classification of maternal cardiovascular risk: application Table 8. Maternal predictors of neonatal events in women with heart disease Table 9. General recommendations Table 10. Recommendations for the management of congenital heart disease Table 11. Recommendations for the management of aortic disease Table 12. Recommendations for the management of valvular heart disease Table 13. Recommendations for the management of coronary artery disease Table 14. Recommendations for the management of cardiomyopathies and heart failure Table 15. Recommendations for the management of arrhythmias Table 16. Recommendations for the management of hypertension Table 17. Check list for risk factors for venous thrombo-embolism Table 18. Prevalence of congenital thrombophilia and the associated risk of venous thrombo-embolism during pregnancy Table 19. Risk groups according to risk factors: definition and preventive measures Table 20. Recommendations for the prevention and management of venous thrombo-embolism in pregnancy and puerperium Table 21. Recommendations for drug use ABPM : ambulatory blood pressure monitoring ACC : American College of Cardiology ACE : angiotensin-converting enzyme ACS : acute coronary syndrome AF : atrial fibrillation AHA : American Heart Association aPTT : activated partial thromboplastin time ARB : angiotensin receptor blocker AS : aortic stenosis ASD : atrial septal defect AV : atrioventricular AVSD : atrioventricular septal defect BMI : body mass index BNP : B-type natriuretic peptide BP : blood pressure CDC : Centers for Disease Control CHADS : congestive heart failure, hypertension, age (>75 years), diabetes, stroke CI : confidence interval CO : cardiac output CoA : coarction of the aorta CT : computed tomography CVD : cardiovascular disease DBP : diastolic blood pressure DCM : dilated cardiomyopathy DVT : deep venous thrombosis ECG : electrocardiogram EF : ejection fraction ESC : European Society of Cardiology ESH : European Society of Hypertension ESICM : European Society of Intensive Care Medicine FDA : Food and Drug Administration HCM : hypertrophic cardiomyopathy ICD : implantable cardioverter-defibrillator INR : international normalized ratio i.v. : intravenous LMWH : low molecular weight heparin LV : left ventricular LVEF : left ventricular ejection fraction LVOTO : left ventricular outflow tract obstruction MRI : magnetic resonance imaging MS : mitral stenosis NT-proBNP : N-terminal pro B-type natriuretic peptide NYHA : New York Heart Association OAC : oral anticoagulant PAH : pulmonary arterial hypertension PAP : pulmonary artery pressure PCI : percutaneous coronary intervention PPCM : peripartum cardiomyopathy PS : pulmonary valve stenosis RV : right ventricular SBP : systolic blood pressure SVT : supraventricular tachycardia TGA : complete transposition of the great arteries TR : tricuspid regurgitation UFH : unfractionated heparin VSD : ventricular septal defect VT : ventricular tachycardia VTE : venous thrombo-embolism WHO : World Health Organization Guidelines summarize and evaluate all available evidence, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient, with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes but are complements for textbooks and cover the European Society of Cardiology (ESC) Core Curriculum topics. Guidelines and recommendations should help the …

1,502 citations


Book
26 Jul 2011
TL;DR: This article estimated glomerular filtration rate of the human glomerus and showed that the estimated rate can be improved by using the enzyme GFR-BPBP-DBPDBPdiastolic blood pressure
Abstract: ACEangiotensin-converting enzymeBPblood pressureDBPdiastolic blood pressureeGFRestimated glomerular filtration rateESCEuropean Society of CardiologyESHEuropean Society of HypertensionETendothelinIM...

837 citations


Journal ArticleDOI
TL;DR: The authors have entered a period of rapidly increasing international inequality in stroke risk, where countries with low adult mortality in the latter 20th century extended their downward trend and countries with moderate as well as high mortality have on average seen unprecedented increases in death rates from stroke.
Abstract: Aims The aim of the present study was to extend our understanding of international trends in stroke and major sequelae in Europe and countries peripheral to Europe by assessing: (1) current mortality rates, (2) the most recent 15-year prevalence trends, and (3) the relationship between systolic blood pressure in community surveys and national stroke mortality. Methods and results Data were obtained from the World Health Organization (WHO [www.who.int/whosis/database/mort/table.cfm][1]), and represent national vital statistics as reported by 39 countries (European and Central Asian countries) using a standard format and population-based cardiovascular surveys. Total numbers of deaths by stroke (International Classification of Diseases 430–438, 444) and the age, sex-adjusted incidence rates were obtained and grouped according to three standard demographic categories: A, B, and C (WHO). A Bayesian linear mixed effect model was fitted to the annual mortality rates. Higher rates of stroke mortality were observed for B and C group countries as compared with those countries belonging to Group A (e.g. Bulgaria 273.9 and 281.1; Israel 37.7 and 45.4 per 100 000 men and women, respectively). Even though the mortality rates within the country groupings were relatively similar, countries with marked deviation from the average were observed, mainly in Groups B and C. Stroke mortality decreased sharply in Group A during the period of study; conversely it had increased substantially in Group B and to a lesser extent in Group C. For both sexes markedly higher rates were noted moving from west to east, with some exceptions. Conclusion We have entered a period of rapidly increasing international inequality in stroke risk, where countries with low adult mortality in the latter 20th century extended their downward trend and countries with moderate as well as high mortality have on average seen unprecedented increases in death rates from stroke. [1]: http://www.who.int/whosis/database/mort/table.cfm

185 citations


Journal ArticleDOI
TL;DR: Evidence is provided that in central and eastern European countries office and ambulatory blood pressure control are unsatisfactory, particularly in patients at very high CV risk, and not differ from that seen in Western Europe.
Abstract: Aims Limited information is available on office and ambulatory blood pressure (BP) control as well as on cardiovascular (CV) risk profile in treated hypertensive patients living in central and eastern European countries. Methods and results In 2008, a survey on 7860 treated hypertensive patients followed by non-specialist or specialist physicians was carried out in nine central and eastern European countries (Albania, Belarus, Bosnia, Czech Republic, Latvia, Romania, Serbia, Slovakia, and Ukraine). Cardiovascular risk assessment was based on personal history, clinic BP values, as well as target organ damage evaluation. Patients had a mean (±SD) age of 60.1 ± 11 years, and the majority of them (83.5%) were followed by specialists. Average clinic BP was 149.3 ± 17/88.8 ± 11 mmHg. About 70% of patients displayed a very high-risk profile. Electrocardiogram was performed in 99% of patients, echocardiography in 65%, carotid ultrasound in 24%, fundoscopy in 68%, and search for microalbuminuria in 10%. Ambulatory BP monitoring was performed in about one-fifth of the recruited patients. Despite the widespread use of combination treatment (87% of the patients), office BP control (<140/90 mmHg) was achieved in 27.1% only, the corresponding control rate for ambulatory BP (<130/80 mmHg) being 35.7%. Blood pressure control was (i) variable among different countries, (ii) worse for systolic than for diastolic BP, (iii) slightly better in patients followed by specialists than by non-specialists, (iv) unrelated to patients’ age, and (v) more unsatisfactory in high-risk hypertensives and in patients with coronary heart disease, stroke, or renal failure. Conclusion These data provide evidence that in central and eastern European countries office and ambulatory BP control are unsatisfactory, particularly in patients at very high CV risk, and not differ from that seen in Western Europe. They also show that assessment of subclinical organ damage is quite common, except for microalbuminuria, and that combination drug treatment is frequently used.

86 citations


Journal ArticleDOI
TL;DR: VĂ˝sledky: V obdobĂ­ 2006-2009 bylo vyĹĄetĹ�’eno celkem 3 612 osob bylo zjistit prevalenci zĂĄkladn â’ch faktorĹŻ u reprezentativn Ă­ho vzorku AŒeskĂS populace.
Abstract: Kardiovaskularni onemocněni jsou hlavni přicinou umrti v Ceske republice. Pokles umrtnosti na kardiovaskularni onemocněni, který je u nas pozorovan od roku 1985, může být způsoben poklesem incidence nebo letality. Letalita onemocněni souvisi předevsim s urovni lecebne pece, zatimco incidence kardiovaskularnich onemocněni je ovlivněna rizikovým profilem obyvatelstva. Cilem teto prace bylo zjistit prevalenci zakladnich rizikových faktorů u reprezentativniho vzorku ceske populace.Metodika: Byl proveden 1% nahodný výběr vzorku populace deviti okresů Ceske republiky ve věku 25-64 let. Vysetřeni sestavalo z vyplněni standardniho dotazniku, ziskani zakladnich antropometrických udajů, opakovaneho měřeni krevniho tlaku a odběru krve.Výsledky: V obdobi 2006-2009 bylo vysetřeno celkem 3 612 osob (1 737 mužů, průměrný věk 47,8 ± 11,48 roku a 1 875 žen, průměrný věk 46,5 ± 11,20 roku); respondence 62,2 %. Průměrna hodnota BMI u nami vysetřene populace cinila 28,5 ± 4,7 kg/m2 u mužů a 27,1 ± 6,0 kg/m2 u žen (p < 0,001). Obezita byla zjistěna u 32,4 % mužů a 28,3 % žen. Mezi vysetřenými muži 31,9 % uvedlo, že jsou pravidelnými kuřaky, zatimco kouřeni u žen bylo zjistěno u 23,3 % (p < 0,001). Nalezli jsme vysokou prevalenci hypertenze (47,8 % u mužů a 36,6 % u žen; p < 0,001); 71,9 % hypertoniků vi o svem onemocněni, 60,3 % je medikamentozně leceno a 30,9 % dosahuje cilových hodnot krevniho tlaku < 140/90 mm Hg. Ženy, ackoli maji nižsi prevalenci hypertenze, castěji vědi o svem onemocněni, castěji jsou medikamentozně leceny pro hypertenzi a castěji dosahuji cilových hodnot krevniho tlaku (< 140/90 mm Hg). Průměrna hodnota celkoveho cholesterolu u nami vysetřene populace byla identicka pro muže i ženy (muži 5,29 ± 1,10 mmol/l; ženy 5,29 ± 1,04 mmol/l). Hypolipidemiky bylo leceno 12,7 % mužů a 8,5 % žen (p < 0,001). Diabetes mellitus byl zjistěn u 9,4 % mužů a 4,7 % žen (p < 0,001). Prevalence vsech zakladnich rizikových faktorů výrazně narůstala s věkem u obou pohlavi (p pro trend < 0,001).Zavěr: U reprezentativniho, nahodně vybraneho vzorku ceske populace středniho věku byla nalezena vysoka prevalence zakladnich rizikových faktorů kardiovaskularnich onemocněni, ktere jsou přicinou stale vysoke kardiovaskularni mortality v Ceske republice.

27 citations


Journal Article
TL;DR: The BOSO ABI device cannot be used interchangeably for standard Doppler ABI measurement in diagnosing PAD, however, its high negative predictive value allows using it as a screening tool for PAD.
Abstract: AIM Ankle brachial index (ABI) is a diagnostic tool for peripheral arterial disease (PAD) and a cardiovascular risk stratification tool. Despite this evidence and guidelines recommending its use in everyday practice, ABI is not widely used. Automatic ABI measurement may lower the barrier to incorporate ABI measurement into everyday practice. The aim of this study was to validate a novel automatic oscillometric ABI device (BOSO ABI) against a gold standard-Doppler device in an epidemiological setting. METHODS In 839 patients from the Czech post-MONICA study (a randomly selected representative population sample aged over 25 years), mean age 54.3±13.8 years (47% of men), ABI measurement was performed using the BOSO ABI device and a handheld Doppler device in a random fashion. The two techniques were carried out by different investigators each blinded to the findings of the other. Analyses were conducted as proposed by Bland and Altman. RESULTS The mean ABI difference between the two methods was 0.1±0.11, with 95% limits of agreement ranging from -0.11 to 0.30. The difference between Doppler and oscillometric ABI increased significantly with increasing mean ABI (r=0.29; P<0.001). When considering Doppler the gold standard, automated oscillometric measurement had a 76.9% sensitivity, 97.9% specificity, and 37% positive and 99.6% negative predictive values in diagnosing ABI <0.9. CONCLUSION The BOSO ABI device cannot be used interchangeably for standard Doppler ABI measurement in diagnosing PAD. However, its high negative predictive value allows using it as a screening tool for PAD.

24 citations


Journal ArticleDOI
TL;DR: This is the first study showing increased aortic stiffness in individuals with high ABI, presumably responsible for increased left ventricular mass described previously in this group, and these findings suggest increased cardiovascular risk of high A BI individuals.
Abstract: Background: Ankle brachial index (ABI) has been increasingly used in general practice to identify individuals with low ABI at high cardiovascular risk. However, there has been no consensus on the clinical significance of high ABI. The aim of our study was to compare aortic stiffness as a marker of cardiovascular risk in individuals with low ( 1.4).Methods: A total of 911 individuals from the Czech post-MONICA study (a randomly selected 1% representative population sample, aged 54 ± 13.5 years, 47% of men) were examined. ABI was measured using a handheld Doppler and aortic pulse wave velocity (aPWV) using the Sphygmocor device.Results: Of the 911 individuals, 28 (3.1%) had low ABI and 23 (2.5%) high ABI. There was a U-shaped association between aPWV and ABI. aPWV was significantly higher in individuals with low and high ABI compared with the normal ABI group (11.1 ± 2.8, 8.3 ± 2.3, p < 0.001; 10.8 ± 2.5, 8.3 ± 2.3 m/s, p < 0.001, respectively). In a model adjusted for...

16 citations


Journal ArticleDOI
TL;DR: Sufficient data regarding treatment of hypertension in pregnancy are lacking as pharmaceutical companies have been reluctant to test drugs in this small market with a high potential of litigation and Pharmaceutical companies are not willing to take any risk and, therefore, no data are available for most of the antihypertensive drugs marketed over the last 20 years.
Abstract: Hypertensive disorders in pregnancy remain a major cause of maternal, fetal and neonatal morbidity and mortality, not only in developing, but also in developed countries Pregnant women with hypert

10 citations


Journal Article
TL;DR: In women with higher fasting glycemia TT genotype of Cx37 polymorphism was protective against subclinical atherosclerosis, therefore, the C x37 gene may exert completely different effects in the artery wall, depending on glyCEmia.
Abstract: AIM The aim of our study was to evaluate a possible association between subclinical atherosclerosis in carotid arteries and the connexin 37 gene polymorphism (1019C>T; Pro319Ser) in a population of urban and rural women METHODS A 5% population sample of urban women aged 45-54 years (N=896) and a 1% representative sample of rural women aged 33-72 years (N=152) were examined using an identical protocol and genotyped for Cx37 gene polymorphism The association between the Cx37 polymorphism and intima-media thickness in common carotid arteries measured by ultrasound (CIMT) was studied RESULTS We have found a different pattern of the effect of the Cx37 gene on CIMT with regard to fasting glycemia with significant interaction between fasting glycemia and Cx37 gene on CIMT (test for equality of slopes P<00001) In addition, we also detected potential threshold effect of fasting glycemia at the concentration of 55 mmol/L (ANCOVA; P=0026) Carriers of TT genotype showed protection against subclinical atherosclerosis if their fasting glycemia was above 55 mmol/L CONCLUSION In women with higher fasting glycemia TT genotype of Cx37 polymorphism was protective against subclinical atherosclerosis Therefore, the Cx37 gene may exert completely different effects in the artery wall, depending on glycemia

5 citations


Journal ArticleDOI
TL;DR: A lower HDL-C in the group of FH patients compared with control subjects was demonstrated and Elevated triglyceride levels were found in FH males and females, except for males with FDB.

4 citations




Journal ArticleDOI
TL;DR: This editorial refers to ‘Blood pressure tracking during pregnancy and the risk of gestational hypertensive disorders’, by R. Gaillard et al, as well as other studies of hypertension in pregnancy, as being of utmost importance.
Abstract: This editorial refers to ‘Blood pressure tracking during pregnancy and the risk of gestational hypertensive disorders. The Generation R Study’, by R. Gaillard et al. doi:10.1093/eurheartj/ehr275 Hypertensive disorders in pregnancy remain a major cause of maternal, fetal, and neonatal morbidity and mortality worldwide. Pregnant women with hypertension are at higher risk for severe complications such as abruption placentae, cerebrovascular accidents, organ failure, and disseminated intravascular coagulation. The fetus is at risk for intrauterine growth retardation, prematurity, and intrauterine death. Hypertension is the most common medical problem in pregnancy, accounting for approximately a quarter of all antenatal admissions. The definition of hypertension in pregnancy was not uniform for a long time;1,2 it used to be defined as an elevation in blood pressure during the second trimester from a baseline reading in the first trimester or from pre-pregnancy levels. However, a definition based on absolute blood pressure values (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) is now preferred. Hypertension in pregnancy is not a single entity but comprises (i) pre-existing hypertension; (ii) gestational hypertension with its subunit of (iii) pre-eclampsia; (iv) pre-existing hypertension with superimposed gestational hypertension with proteinuria; and (v) antenatally unclassifiable hypertension ( Table 1 ). View this table: Table 1 Classification of hypertension in pregnancy Identification of the risk factors associated with gestational hypertension, and with pre-eclampsia in particular, would be of utmost importance. Table 2 shows factors …